A Snapshot of Colorectal Cancer

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Incidence and Mortality

Colorectal cancer is the third most common non-skin cancer in both men and women. It is the second leading cause of cancer-related mortality in the United States. Over the past decade, colorectal cancer incidence and mortality rates have decreased in all racial/ethnic populations except American Indians/Alaska Natives. Men and women have similar incidence rates through age 39; at and above age 40, rates are higher in men.

Differences exist between racial/ethnic groups in both incidence and mortality. African Americans have higher mortality rates than all other racial/ethnic groups and higher incidence rates than all except American Indians/Alaska Natives. Incidence and mortality rates are lowest among Hispanics and Asians/Pacific Islanders. Overall colorectal cancer incidence and mortality rates have been declining over the past two decades; these declines have been attributed largely to increased use of screening tests.

Risk factors for colorectal cancer include increasing age, colorectal polyps, a family history of colorectal cancer, certain genetic mutations, excessive alcohol use, obesity, being physically inactive, cigarette smoking, and a history of inflammatory bowel disease. Effective colorectal cancer screening tests include the fecal occult blood test, sigmoidoscopy, and colonoscopy. Standard treatments for colorectal cancer include surgery, chemotherapy, radiation therapy, cryosurgery, radiofrequency ablation, and targeted therapy.

Assuming that incidence and survival rates follow recent trends, it is estimated that $13.8 billion1 will be spent on colorectal cancer care in the United States in 2014.

Line graphs showing U.S. Colorectal Cancer Incidence and mortality per 100,000, by race and ethnicity.  Incidence from 1991-2011 and mortality from 1990-2010 is shown. In 2011, American Indians/Alaska Natives have the highest incidence, followed by African Americans, whites, Asians/Pacific Islanders, and Hispanics. In 2010, African Americans have the highest mortality followed by American Indians/Alaska Natives, whites, Hispanics, and Asians/Pacific Islanders.

Source: Surveillance, Epidemiology, and End Results (SEER) Program and the National Center for Health Statistics. Additional statistics and charts are available at the SEER Web site.

NCI’s Investment in Colorectal Cancer Research

To learn more about the research NCI conducts and supports in colorectal cancer, visit the NCI Funded Research Portfolio (NFRP). The NFRP includes information about research grants, contract awards, and intramural research projects funded by NCI. When exploring this information, it should be noted that approximately half of the NCI budget supports basic research that may not be specific to one type of cancer. By its nature, basic research cuts across many disease areas, contributing to our knowledge of the underlying biology of cancer and enabling the research community to make advances against many cancer types. For these reasons, the funding levels reported in NFRP may not definitively report all research relevant to a given category.

Pie chart of NCI Colorectal Cancer Research Portfolio.  Percentage of total dollars by scientific area.  Fiscal year 2013.  Biology, 18%.  Etiology/causes of cancer, 16%.  Prevention, 12%.  Early detection, diagnosis, and prognosis, 15%.  Treatment, 19%.  Cancer control, survivorship, and outcomes research, 16%.  Scientific model systems 4%.

Source: NCI Funded Research Portfolio. Only projects with assigned common scientific outline area codes are included. A description of relevant research projects can be found on the NCI Funded Research Portfolio Web site.

Other NCI programs and activities relevant to colorectal cancer include:

Selected Advances in Colorectal Cancer Research

  • A preclinical study has shown that gut microflora can influence the treatment response of tumors formed by colon carcinoma cells. Published November 2013. [PubMed Abstract]
  • In a study comparing the gut microflora of colorectal cancer patients and noncancer controls, colorectal cancer risk was associated with decreased bacterial diversity. Published December 2013. [PubMed Abstract]
  • Overexpression of PLAC8, a protein whose levels are elevated in colon cancer, shifts the normal cells lining the colon into a state that encourages metastasis. Published April 2014. [PubMed Abstract]
  • The integration of proteomic and genomic data from colorectal cancer studies identified five colon cancer subtypes (three of which were unique to this combined analysis) and demonstrated the value of using proteomics to understand the mutations that drive cancer. Published July 2014. [PubMed Abstract]

Additional Resources for Colorectal Cancer

  • Posted: November 5, 2014