Colorectal Cancer Could Become Oncology's Biggest Challenge

Cancers of the colon and rectum, the two parts of the large intestine, are known as colorectal cancer. Their rising incidence presents a major challenge for oncology in both the United States and Europe. US Cancer Statistics 2024 shows an increase in new cases and declining mortality among older Americans. The American Cancer Society expects 152,810 new colorectal cancer cases this year, most of them colon cancers. While incidence is rising among young adults and overall cancer mortality is expected to fall, increasing numbers of new cases could bring that decline to a halt. This trend highlights the importance of stronger colorectal cancer prevention and early detection policies.

Colorectal Cancer Was the Most Striking Finding in US Cancer Statistics

US Cancer Statistics 2024 identified important changes in colorectal cancer. Although the number of new cases has increased, mortality among older Americans has declined.

The American Cancer Society estimates 152,810 new colorectal cancer cases in 2024: 81,540 in men and 71,270 in women. Of these, 106,590 are colon cancers and 46,220 rectal cancers. Colorectal cancer is the second leading cause of cancer-related death in the United States (lung cancer remains the leading cause). An estimated 53,010 deaths from colorectal cancer are expected in 2024, a slight increase over last year

The Leading Cause of Death Under Age 50

Among people younger than 55, colorectal cancer incidence (the annual rate of new cases) has risen by 1% to 2% each year since the 1990s. Mortality among young people has also increased by about 1% per year since the mid-2000s. Colorectal cancer is now the leading cause of cancer-related death in men under 50 and ranks second among women in the same age group. Young people are often diagnosed with more advanced cancers because of delays in detection.

Among older Americans, however, survival for colorectal cancer has improved. Mortality has fallen by 55% in men since 1980 and by 60% in women since 1969. More recently, during 2012-2021, mortality declined by 1.8% annually among men and women aged 55 and older.

In addition, the lifetime risk of developing colorectal cancer is 1 in 23 for men and 1 in 25 for women according to these estimates.

Obesity, a low-fiber diet, a Western-style diet, inactivity, alcohol and family history can increase a person's risk of developing colorectal cancer. The risk also rises with age.

Although overall cancer mortality continues to decline thanks to treatment advances, increasing numbers of new cancer cases may bring this decline to a halt in the near future.

The factors affecting colorectal cancer risk are shown below:

Not Just a US Problem!

Colorectal cancer could become one of oncology's biggest challenges in the United States, European Union and United Kingdom. Rising incidence has also been confirmed in Europe, with findings that overweight and obesity are increasing colon cancer mortality among young patients. On January 28, 2024, Annals of Oncology published the study.

Although colon cancer mortality is declining overall in the European Union, it is rising among young patients. This increase in European colon cancer mortality has been associated with factors such as lifestyle choices and population aging.

In Europe, colon cancer mortality in 2024 is expected to fall by 5% to 15 per 100,000 among men and by 9% to 8 among women. In the United Kingdom, it is projected to fall by 3% to 14 among men, while remaining stable at around 10 per 100,000 among women. These generally favorable trends may be explained by improvements in diagnosis and treatment. However, rising mortality among young patients is concerning, with overweight, obesity and related health conditions among the important contributing factors.

Cancer Mortality Rates Are Falling

Figure description: The graph shows cancer mortality rates in the European Union from 1970 to 2019 and predictions for 2024. Overall, rates for all cancers have declined over time. Lung cancer has the highest mortality rate among men, while breast cancer has the highest among women. However, lung cancer mortality is also rising among women. The decline in colorectal cancer mortality in both sexes is particularly notable, but rising colorectal cancer incidence, especially among younger people, is concerning. Prostate and pancreatic cancers in men, and uterine, ovarian, stomach and bladder cancers in women, also show substantial declines. These data reflect the effects of advances in cancer detection and treatment.