Cancer Research UK : UK Bowel Cancer incidence statistics

UK Bowel Cancer incidence statistics

Cancer of the large bowel (also known as colorectal cancer) is a common form of malignancy in developed countries but occurs much less frequently in the developing world.

This page presents bowel cancer incidence statistics by age and sex,socio-economic deprivation, geographic variation, trends over time and prevalence. The ICD code for colorectal cancer is ICD9 153-154 and ICD10 C18-21.

Bowel cancer incidence by age and sex

Around 100 new cases of colorectal cancer are diagnosed each day in the UK and it is the third most common cancer after breast and lung. In 2005 there were 36,766 new cases of large bowel cancer registered in the UK: around two-thirds (22,748) in the colon and one-third (14,018) in the rectum.1-4

The distribution of cases throughout the large bowel is shown in Figure 1.1.5 The left side of the bowel is affected by cancer more often than the right: tumours in the sigmoid colon, rectosigmoid junction and the rectum together account for over half of all cases.

Chart showing the percentage distribution of new cases, by site, within the large bowel, England 1997-2000

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The number of cases of colorectal cancer and the incidence rates in each of the countries of the UK are shown in Table 1.1.1-4

Table showing the number of new cases and rates for bowel cancer in the UK

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The occurrence of large bowel cancer is strongly related to age, with 83% of cases arising in people who are 60 years or older (Figure 1.2).1-4 Until age 50, men and women have similar rates for bowel cancer, but in later life male rates predominate. In numerical terms, there are more male cases of bowel cancer up to the age of 80, after which female cases are in the majority, even though their rates are lower, as women make up a larger proportion of the elderly population. Overall the male:female ratio is 1.2:1.0.

Chart showing the number of new and cases and age-specific incidence rates for bowel cancer by sex in the UK

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Using England and Wales data, the lifetime risk for men of being diagnosed with colorectal cancer is estimated to be 1 in 18 and for women 1 in 20.6 At present, colorectal cancer is the second most common cancer in women after breast cancer whereas in men it ranks third after prostate and lung cancer.

The male age-standardised rates are higher for than the female rates for both colon and rectal cancer (Table 1.2).7

Table showing the number of cases and rates of colon and rectal cancer by sex for the UK, 2005

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Bowel cancer incidence and socio-economic deprivation

In general there are no strong socio-economic deprivation gradients reported for colorectal cancer incidence. However, data for England and Wales patients diagnosed between 1992-1993 did show a deprivation gradient for male rectal cancer patients with incidence rates 25% higher in the most deprived groups than in the affluent groups.6

Geographic variation of bowel cancer incidence

A recent geographical analysis of cancer incidence in the UK and Ireland, showed that the geographical distribution was similar for colon and rectal cancer and that on the whole the variation was relatively small, especially when compared to other major cancers such as lung and stomach.8 Scotland, Northern Ireland and Ireland had higher than average (UK and Ireland) rates as Figure 1.3 shows, and London, Trent and Eastern had lower than average rates.8

Chart showing the age-standardised incidence rates for bowel cancer, by sex, for the regions of England, the UK and Ireland, 1991-1999

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In 2006 there were an estimated 307,432 new cases of colorectal cancer in the European Union (EU).19 The rates varied by a factor of two for women and three for men. The lowest rates were in Greece and the highest were in Hungary and the Czech Republic (Figure 1.4).10,19 Rates for the UK were just below the EU average.

Figure 1.4: Age standardised (European) incidence rates, by sex, bowel cancer, EU countries,

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In Europe, the incidence of colorectal cancer is increasing, particularly in southern and eastern Europe, where rates were originally lower than in western Europe.12, 13 In the USA, incidence rose until the mid-1980s but in the last two decades rates have fallen for both men and women.14

Worldwide over a million new cases of colorectal cancer were diagnosed in 2002, accounting for more than 9% of all new cancer cases.9

Epidemiological studies report a rapid increase in risk for colorectal cancer in migrants moving from low to high risk countries15 and the rates for second generation migrants can be double that of first.16

Countries that have had a rapid ‘westernisation’ of diet , such as Japan, have seen a rapid increase in the incidence of colorectal cancer.17,18 Consumption of meat and dairy products in Japan increased ten-fold between the 1950s and 1990s.

Bowel cancer is the third most common cancer worldwide after lung and breast with two-thirds of all colorectal cancers occurring in the more developed regions. Figure 1.5 shows the large variation in rates, with the lowest rates in Africa and Asia and the highest in Europe, Northern America and Australasia.9

Differences of this magnitude, together with migration data (see Trends section below), suggest that many cases of colorectal cancer could be prevented.Japan is an exception to other countries in the Eastern Asia region with age-standardised rates similar to other highly developed countries.

Figure 1.5: Age standardised (European) incidence rates, by sex, colorectal cancer, GB

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Bowel cancer incidence trends

The bowel cancer incidence trend is shown in Figure 1.6 for the UK, and in Figure 1.7 for Great Britain. 2, 3, 11

Chart showing the age standardised (European) incidence rates for bowel cancer by sex in the UK

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In Great Britain male bowel cancer incidence rates rose slowly by an average of 1% each year between 1979 and 1999, since when there has been a slight decrease. Over the same period the female rates have changed very little. 7

Chart showing the age standardised (European) incidence and mortality rates by sex for bowel cancer in Great Britain

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Bowel cancer prevalence

As the incidence of bowel cancer is high and survival rates have doubled over the last 30 years there are many people alive today who have been diagnosed with bowel cancer. An estimated 250,000 people are alive in the UK having received a diagnosis of bowel cancer. General information about cancer prevalence in the UK can be found in the Prevalence section of the CancerStats website

References for bowel cancer incidence

Office for National Statistics, Cancer Statistics registrations: Registrations of cancer diagnosed in 2005, England
Welsh Cancer Intelligence and Surveillance Unit. 2008
ISD Online 2008. Cancer incidence and mortality data.
Northern Ireland Cancer Registry 2008. Cancer statistics
Toms J R(ed), CancerStats Monograph 2004. Cancer Research UK: London 2004.
Quinn, M., et al., Cancer Trends in England & Wales 1950-1999. Vol. SMPS No. 66. 2001: TSO.
Cancer Research UK, CancerStats Incidence - UK.
Quinn M, W.H., Cooper N, Rowan S, Cancer Atlas of the United Kingdom and Ireland 1991-2000 National Statistics 2005.
IARC, GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worldwide (2002 estimates). 2005.
Statistical Information Team, Cancer Research UK
Office for National Statistics.
Coleman, M., et al., Trends in Cancer Incidence and Mortality. ed. IARC Scientific Publications, ed. Vol. 121. 1993, Lyon: IARC.
Bray, F. Atkin,W., International cancer patterns in men: geographical and temporal variations in cancer risk and the role of gender. JMHG, 2004. 1(1): p. 38-46.
National Cancer Institute. Surveillance, Epidemiology and End Results (SEER) 2006
Boyle, P. and J. Langman, ABC of colorectal cancer: Epidemiology BMJ, 2000. 321: p. 805-808.
Flood, D., et al., Colorectal cancer incidence in Asian migrants to the United States and their decendants. Cancer Causes Control, 2000. 11(5): p. 403-411.
Marchand, L., Combined influence of genetic and dietary factors on colorectal cancer incidence in Japanese Americans. J Natl Cancer Inst Monogr, 1999. 26: p. 101-105.
Koyama, Y. and K. Kotake, Overview of colorectal cancer in Japan: report from the Registry of the Japanese Society for Cancer of the Colon and Rectum. Dis Colon Rectum, 1997. 40(10 Supplement): p. S2-9.
J. Ferlay, P. Autier, M. Boniol, M. Heanue, M. Colombet, P. Boyle. Estimates of the cancer incidence and mortality in Europe in 2006 Ann Oncol. 2007 Mar;18(3):581-92.