ABSTRACT
Colorectal cancer is one of the most commonly diagnosed cancers, and a leading cause of cancer deaths, around the world. The high incidence countries include all of North America, Western Europe, Japan, Australia, and New Zealand. They also include Argentina, Israel, Singapore, Hong Kong, and parts of Malaysia. The relative incidence of different cancers varies with a country’s level of economic development. In the developed regions of the world, colorectal cancer is the third most common malignancy after lung and stomach in males and after breast in women (Tables 1.1 and 1.2; see also Chapter 2, Figures 2.1 and 2.4). However, in terms of national health burden, mortality reflects not only incidence, but also availability of diagnostic services and therapy. As can be seen in Figure 1.1, mortality from colorectal cancer is very high throughout Eastern Europe and what was previously known as the Soviet Union, as well as in most of the other countries mentioned above. In 1990, it was the fourth most common cancer diagnosed and the fourth most common cause of cancer mortality in men worldwide; and the third most common cancer diagnosed and the fourth
most common cause of cancer mortality in women.1 In the USA, for example, colorectal cancer is the third most commonly diagnosed cancer, with an estimated 130 200 new cases in the year 2000; it is the second leading cause of cancer mortality there, accounting for an estimated 56 300 deaths in that year.2 The cost of treating patients with colorectal cancer is significant. It is estimated that in the USA, these costs approach $6.5 billion per year. This is second in cancer treatment costs only to breast cancer, at $6.6 billion per year, and exceeds the costs of treating lung cancer at $5.1 billion per year and prostate cancer at $4.7 billion per year.3
