Colorectal Cancer

  • Thad WilkinsEmail author
  • Jillian Soto
  • Temitope I. Afon
  • Dean A. Seehusen
Living reference work entry


Colorectal cancer (CRC) is the third most common cancer in men after lung and prostate cancer and women after breast and lung cancer [1]. In 2019, the American Cancer Society estimated that 101,420 cases of colon cancer and 44,180 cases of rectal cancer would be diagnosed, and 27,640 men and 23,380 women would die from CRC [1]. The mortality from CRC has been decreasing for several decades due to improved CRC screening, risk factor modification, and better treatments. Over the last 15 years, the incidence of CRC in adults 55 years and older decreased by 3.7% per year, while the incidence in adults less than 55 years old decreased by 1.8% [1].


  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Salaria SN, Streppel MM, Lee LA, Iacobuzio-Donahue CA, Montgomery EA. Sessile serrated adenomas: high-risk lesions? Hum Pathol. 2012;43(11):1808–14.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Amersi F, Agustin M, Ko CY. Colorectal cancer: epidemiology, risk factors, and health services. Clin Colon Rectal Surg. 2005;18(3):133–40.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Kanth P, Grimmett J, Champine M, Burt R, Samadder NJ. Hereditary colorectal polyposis and cancer syndromes: a primer on diagnosis and management. Am J Gastroenterol. 2017;112(10):1509–25.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Botteri E, Iodice S, Raimondi S, Maisonneuve P, Lowenfels AB. Cigarette smoking and adenomatous polyps: a meta-analysis. Gastroenterology. 2008;134(2):388–95.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Durko L, Malecka-Panas E. Lifestyle modifications and colorectal cancer. Curr Colorectal Cancer Rep. 2014;10:45–54.PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Yang YJ, Bang CS, Choi JH, Lee JJ, Shin SP, Suk KT, et al. Alcohol consumption is associated with the risk of developing colorectal neoplasia: propensity score matching analysis. Sci Rep. 2019;9(1):8253.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Dong Y, Zhou J, Zhu Y, Luo L, He T, Hu H, et al. Abdominal obesity and colorectal cancer risk: systematic review and meta-analysis of prospective studies. Biosci Rep. 2017;37(6):1–12. chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/ Scholar
  9. 9.
    Soltani G, Poursheikhani A, Yassi M, Hayatbakhsh A, Kerachian M, Kerachian MA. Obesity, diabetes and the risk of colorectal adenoma and cancer. BMC Endocr Disord. 2019;19(1):113.PubMedPubMedCentralCrossRefGoogle Scholar
  10. 10.
    Yuhara H, Steinmaus C, Cohen SE, Corley DA, Tei Y, Buffler PA. Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol. 2011;106(11):1911–21; quiz 22PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Tariq K, Ghias K. Colorectal cancer carcinogenesis: a review of mechanisms. Cancer Biol Med. 2016;13(1):120–35.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. multi-society task Force on colorectal cancer. Am J Gastroenterol. 2017;112(7):1016–30.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Hadjipetrou A, Anyfantakis D, Galanakis CG, Kastanakis M, Kastanakis S. Colorectal cancer, screening and primary care: a mini literature review. World J Gastroenterol. 2017;23(33):6049–58.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Lin JS, Piper MA, Perdue LA, Rutter CM, Webber EM, O$Connor E, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US preventive services task Force. JAMA. 2016;315(23):2576–94.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Expert Panel on Gastrointestinal I, Moreno C, Kim DH, Bartel TB, Cash BD, Chang KJ, et al. ACR appropriateness criteria(R) colorectal cancer screening. J Am Coll Radiol. 2018;15(5S):S56–68.Google Scholar
  16. 16.
    Force USPST, Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW Jr, et al. Screening for colorectal cancer: US preventive services task Force recommendation statement. JAMA. 2016;315(23):2564–75.CrossRefGoogle Scholar
  17. 17.
    Rex DK, Boland CR, Dominitz JA, Giardiello FM, Johnson DA, Kaltenbach T, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. multi-society task force on colorectal cancer. Gastrointest Endosc. 2017;86(1):18–33.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Wolf AMD, Fontham ETH, Church TR, Flowers CR, Guerra CE, LaMonte SJ, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018;68(4):250–81.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Helsingen LM, Vandvik PO, Jodal HC, Agoritsas T, Lytvyn L, Anderson JC, et al. Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy: a clinical practice guideline. BMJ. 2019;367:l5515.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Wilkins T, McMechan D, Talukder A. Colorectal cancer screening and prevention. Am Fam Physician. 2018;97(10):658–65.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Committee ASoP, Saltzman JR, Cash BD, Pasha SF, Early DS, Muthusamy VR, et al. Bowel preparation before colonoscopy. Gastrointest Endosc. 2015;81(4):781–94.CrossRefGoogle Scholar
  22. 22.
    Jang HJ. Training in endoscopy: colonoscopy. Clin Endosc. 2017;50(4):322–7.PubMedPubMedCentralCrossRefGoogle Scholar
  23. 23.
    Kastenberg D, Bertiger G, Brogadir S. Bowel preparation quality scales for colonoscopy. World J Gastroenterol. 2018;24(26):2833–43.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
    Jessup JM, Goldberg R, Aware EA, et al. Colon and rectum. In: AJCC Cancer Staging Manual. 8th ed.; 2017. 251p.Google Scholar
  25. 25.
    Herszenyi L. The “difficult” colorectal polyps and adenomas: practical aspects. Dig Dis. 2019;37(5):394–9.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Kuipers EJ, Grady WM, Lieberman D, Seufferlein T, Sung JJ, Boelens PG, et al. Colorectal cancer. Nat Rev Dis Primers. 2015;1:15065.PubMedPubMedCentralCrossRefGoogle Scholar
  27. 27.
    Burgers K, Moore C, Bednash L. Care of the colorectal cancer survivor. Am Fam Physician. 2018;97(5):331–6.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Dekker E, Tanis PJ, Vleugels JLA, Kasi PM, Wallace MB. Colorectal cancer. Lancet. 2019;394(10207):1467–80.CrossRefGoogle Scholar
  29. 29.
    Cho E, Smith-Warner SA, Spiegelman D, Beeson WL, van den Brandt PA, Colditz GA, et al. Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies. J Natl Cancer Inst. 2004;96(13):1015–22.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Schmit SL, Rennert HS, Rennert G, Gruber SB. Coffee consumption and the risk of colorectal cancer. Cancer Epidemiol Biomark Prev. 2016;25(4):634–9.CrossRefGoogle Scholar
  31. 31.
    Yao Y, Suo T, Andersson R, Cao Y, Wang C, Lu J, et al. Dietary fibre for the prevention of recurrent colorectal adenomas and carcinomas. Cochrane Database Syst Rev. 2017;1:CD003430.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Dai Z, Xu YC, Niu L. Obesity and colorectal cancer risk: a meta-analysis of cohort studies. World J Gastroenterol. 2007;13(31):4199–206.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Afshar S, Kelly SB, Seymour K, Lara J, Woodcock S, Mathers JC. The effects of bariatric surgery on colorectal cancer risk: systematic review and meta-analysis. Obes Surg. 2014;24(10):1793–9.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Ferrari P, Jenab M, Norat T, Moskal A, Slimani N, Olsen A, et al. Lifetime and baseline alcohol intake and risk of colon and rectal cancers in the European prospective investigation into cancer and nutrition (EPIC). Int J Cancer. 2007;121(9):2065–72.PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Wang YM, Zhou QY, Zhu JZ, Zhu KF, Yu CH, Li YM. Systematic review with meta-analysis: alcohol consumption and risk of colorectal serrated polyp. Dig Dis Sci. 2015;60(7):1889–902.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev. 2005;3:CD003548.Google Scholar
  37. 37.
    Zhang X, Keum N, Wu K, Smith-Warner SA, Ogino S, Chan AT, et al. Calcium intake and colorectal cancer risk: results from the nurses’ health study and health professionals follow-up study. Int J Cancer. 2016;139(10):2232–42.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Jung YS, Park CH, Eun CS, Park DI, Han DS. Statin use and the risk of colorectal adenoma: a meta-analysis. J Gastroenterol Hepatol. 2016;31(11):1823–30.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Bibbins-Domingo K, Force USPST. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2016;164(12):836–45.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Bertagnolli MM, Eagle CJ, Zauber AG, Redston M, Solomon SD, Kim K, et al. Celecoxib for the prevention of sporadic colorectal adenomas. N Engl J Med. 2006;355(9):873–84.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Dulai PS, Singh S, Marquez E, Khera R, Prokop LJ, Limburg PJ, et al. Chemoprevention of colorectal cancer in individuals with previous colorectal neoplasia: systematic review and network meta-analysis. BMJ. 2016;355:i6188.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Rennert G, Rennert HS, Pinchev M, Lavie O, Gruber SB. Use of hormone replacement therapy and the risk of colorectal cancer. J Clin Oncol. 2009;27(27):4542–7.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Weir HK, Stewart SL, Allemani C, White MC, Thomas CC, White A, et al. Population-based cancer survival (2001 to 2009) in the United States: findings from the CONCORD-2 study. Cancer. 2017;123(Suppl 24):4963–8.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Sarma EA, Kawachi I, Poole EM, Tworoger SS, Giovannucci EL, Fuchs CS, et al. Social integration and survival after diagnosis of colorectal cancer. Cancer. 2018;124(4):833–40.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Dominic OG, McGarrity T, Dignan M, Lengerich EJ. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Am J Gastroenterol. 2009;104(10):2626–7; author reply 8–9PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Lin JS, Piper MA, Perdue LA, Rutter C, Webber EM, O’Connor E, et al. Screening for Colorectal Cancer: A Systematic Review for the US Preventive Services Task Force. U.S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews, Rockville; 2016.Google Scholar
  47. 47.
    Qaseem A, Crandall CJ, Mustafa RA, Hicks LA, Wilt TJ. Clinical guidelines committee of the American College of P. Screening for colorectal cancer in asymptomatic average-risk adults: a guidance statement from the American College of Physicians. Ann Intern Med. 2019;171(9):643–54.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2020

Authors and Affiliations

  • Thad Wilkins
    • 1
    Email author
  • Jillian Soto
    • 1
  • Temitope I. Afon
    • 1
  • Dean A. Seehusen
    • 1
  1. 1.Department of Family Medicine, Medical College of GeorgiaAugusta UniversityAugustaUSA

Personalised recommendations