Colorectal Cancer

Authors: Linda Rabeneck, Susan Horton, Ann G. Zauber, Craig Earle

Abstract 

Colorectal cancer (CRC) is the third most common cancer in men and second most common in women worldwide, but mortality rates are lower for women than men. While incidence rates are stabilized and declining in high-income countries (HICs) due to decreased smoking, only approximately 31 percent of men and 30 percent of women with CRC die of this cancer. Diet, lifestyle, and medications present risk factors for CRC as do genetic factors. Screening tests and diagnosis include fecal occult blood and fecal immunochemical tests, flexible sigmoidoscopy, colonscopy, and fecal DNA; guidelines for screening have been developed by the International Agency for Research on Cancer, U.S. Preventive Services Task Force, and U.S. Multi-Society Task Force/American Cancer Society. Staging to determine the extent of the disease involves imaging, and the cornerstone treatment is surgery, with preoperative radiotherapy and postoperative chemotherapy. Cost-effectiveness analysis is presented by country income levels and does not select which strategy is economically preferred overall, but only which strategy makes a difference in terms of life years gained.