ABSTRACT
Colorectal cancer (CRC) is a common cancer and its burden is expected to increase in the coming years with growing and aging populations as well as the increasing prevalence of some of its risk factors. A minority of cases are due to inherited genetic conditions. A large proportion of CRC, possibly up to half of all cases, can be attributed to an unhealthy diet (e.g. a diet low in whole grain and high in processed meat), tobacco use, high body mass index and low physical activity. This emphasizes the significant role of interventions in multiple sectors to reduce the exposure to these risk factors in the whole population. Systematic screening, for example between the age of 50 and 74 years, using faecal blood tests and/or colonoscopy, is used where resources allow. Colorectal cancer is generally preceded by pre-cancerous lesions (polyps) and colonoscopy can identify and remove them at the time of screening. Treatment requires surgery and a mix of radiotherapy and/or systemic chemotherapy (which may be tailored according to selected immune-markers), and palliative care. As for all cancers, there is a need for networks of care, with centres of excellence that can provide high quality multidisciplinary care, as well as ensuring that treatment is included into universal health care packages at no or minimal cost to the patients.
