Colorectal Cancer

The majority of patients with sporadic cancer are >50 years of age, with 75% of patients with rectal cancer and 80% of patients with colon cancer patients being ≥60 years of age at the time of diagnosis.
Based on current incidence and mortality rates as well as on projected demographic changes in the world population for the coming decades, the World Health Organization (WHO) estimates an increase of 77% in the number of newly diagnosed CRC cases and an increase of 80% in deaths from CRC by 2030. Most of the additional incidence and mortality would occur in the world’s less developed regions. This estimation could be higher if developing countries continue with an increasingly Westernized lifestyle

The prevalence of the disease is higher in more industrialized countries, such as the USA and Western Europe, being lower in Africa or South America.
Over 70% of CRC cases are sporadic and thus related to lifestyle. Despite being one of the most common cancers, CRC is also one that could benefit most from prevention through primary and secondary prevention strategies, and it is estimated that between 66% and 75% of CRC cases could be avoided with a healthy lifestyle.

The known risk factors for CRC are as follows: a diet low in fruit and vegetables, excessive intake of red meat and saturated fat, alcohol intake, a sedentary lifestyle, tobacco and being overweight. However, the main risk factor is age. From 50 onwards, CRC is much more frequent, and the incidence increases exponentially with age.
However various techniques are available to detect CRC in its early stages or as precursor lesions, thereby preventing aggressive treatment. Moreover,  Unlike screening programs for breast and prostate cancers, not only has CRC screening reduced mortality from colon cancer and detected early CRC, it has also decreased the incidence of CRC through detection and removal of pre-cancerous lesions.

Surgery is the mainstay curative treatment for patients with non-metastasized colorectal cancer. However, outcome is strongly related to the quality of surgery, the quality of pre-operative staging and treatment selection. Chemotherapy remains the cornerstone of systemic treatment today, but several new targeted drugs have emerged in this filed in the last decade, improving the management of metastatic disease. The recent advances in molecular biology and the genetic classification of CRC are essential to individualize these therapies and will be basic for improving the treatment in the next years.