Bowel cancer mortality statistics

Bowel cancer is the second most common cause of cancer death in the UK (2010), accounting for around 10% of all cancer deaths. Bowel cancer is the third most common cause of cancer death among men in the UK (2010), accounting for 10% of all male deaths from cancer.1-3 Among women in the UK, bowel cancer is also the third most common cause of cancer death (2010), responsible for 10% of all female cancer deaths.

In 2010, there were 15,708 deaths from bowel cancer in the UK (Table 2.1): 8,574 (55%) in men and 7,134 (45%) in women, giving a male:female ratio of 12:10.1-3 These comprised 9,806 (62%) deaths from colon cancer and 5,902 (38%) deaths from rectal cancer (including the anus). Most rectal cancer deaths are in men (3,608 or 61% male) but colon cancer deaths are approximately evenly divided between men and women (4,966 or 51% male). The crude mortality rate shows that there are 28 bowel cancer deaths for every 100,000 males in the UK and 23 for every 100,000 females.

The European age-standardised mortality rates (AS rates) are significantly lower in England compared with Wales (males only) and Scotland.1-3 Rates do not differ significantly between the other constituent countries of the UK for either sex.

Table 2.1: Bowel Cancer (C18-C21), Number of Deaths, Crude and European Age-Standardised (AS) Mortality Rates per 100,000 Population, UK, 2010

*95% LCL and 95% UCL are the 95% lower and upper confidence limits around the AS rate

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A north-south divide in bowel cancer mortality rates has existed across the UK since at least the 1990s;12 the latest analysis of bowel cancer mortality rates throughout the UK reports significant variation between cancer networks for males, with the highest rates in England being in the north and the lowest rates being in parts of London and the south. A clear divide is less evident for females.4

section reviewed 03/04/13
section updated 03/04/13

Bowel cancer mortality is strongly related to age, with the highest mortality rates being in older men and women. In the UK between 2008 and 2010, an average of 80% of bowel cancer deaths were in men and women, aged 65 years and over (Figure 2.1).1-3  Age-specific mortality rates increase sharply from around age 50 in men and around age 65 in women, with the highest rates in the in the 85+ age group in both sexes. Mortality rates are higher for males than for females in adults aged 45 and over and this gap is widest between the ages of 60 and 74, when the male:female mortality ratio of age-specific mortality rates (to account for the different proportions of males to females in each age group) is around 18:10 (Figure 2.1).1-3

Figure 2.1: Bowel Cancer (C18-C20) Average Number of Deaths per Year and Age-Specific Mortality Rates, UK, 2008-2010

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19% of bowel cancer deaths occur in people aged 60-69. People in England and Northern Ireland are currently offered bowel screening at two-year intervals between ages 60 and 69. In Scotland people are offered screening from ages 50 to 74. In Wales people are offered screening from ages 60 to 74. In England screening is gradually being extended to include people aged 70-74.

section reviewed 03/04/13
section updated 03/04/13

Bowel cancer mortality rates have overall decreased in the UK since the early 1970s (Figure 2.2).1-3 For males, European AS mortality rates decreased by 36% between 1971-1973 and 2008-10. The decline is bigger for females, with rates decreasing by 50% between 1971-1973 and 2008-2010.

For both sexes, UK bowel cancer mortality rates decreased steadily from the early 1970s to the early 1990s, and have decreased more rapidly since then. Between 1971-1973 and 1992-1994 male mortality rates fell by 6% (from 34 per 100,000 males to 30 per 100,000), whilst female rates fell by 21% (from 26 per 100,000 females to 19 per 100,000). Then between 1992-1994 and 2008-2010 mortality rates further decreased by 33% and 29% in males and females, respectively, to 21 per 100,000 males and 13 per 100,000 females. Over the last decade (between 1999-2001 and 2008-2010), the European AS mortality rates have decreased by 14% in both males and females. 

There are probably a combination of reasons for the decline in bowel cancer mortality rates, including earlier detection and better treatment. 

Bowel screening pilot studies conducted from 2000 onwards in the West Midlands and Scotland have shown that the risk of dying from bowel cancer is reduced by around a quarter in people who are screened.13,15 Bowel screening started in England for 60-69 year olds in 2006. The impact of the nationwide screening programmes on mortality rates should be seen in the data in the coming years.

Figure 2.2: Bowel Cancer (C18-C20), European Age-Standardised Mortality Rates, UK, 1971-2010

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Bowel cancer mortality rates have overall decreased for all of the broad age groups in the UK in the last 40 years (Figure 2.3).1-3 The largest decreases have been in people aged between 45 and 59, with European AS mortality rates decreasing by 50% between 1971-1973 and 2008-2010. Lower mortality decreases in age groups over 60 may be explained in part by the under-staging and under-treatment of the elderly.5 The impact of screening on mortality rates in different age groups should be seen in the data in the coming years.

Figure 2.3: Bowel Cancer (C18-20), European Age-Standardised Mortality Rates, Persons, By Age, UK, 1971-2010

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section reviewed 03/04/13
section updated 03/04/13

Bowel cancer (including anal cancer; C18-C21) is the fourth most common cause of cancer death worldwide, estimated to be responsible for almost 610,000 deaths in 2008 (around 8% of the total). Mortality rates are lowest in Middle Africa and South-Central Asia and highest in Central and Eastern Europe, with a six-fold variation in male mortality rates between the regions of the world, and a five-fold variation in female rates (Figure 2.4).6

Figure 2.4: Bowel Cancer including anal (C18-C21), World Age-Standardised Mortality Rates, World Regions, 2008 Estimates

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Within the 27 countries of the European Union (EU-27), the highest bowel cancer (including anal cancer) mortality rates are in Hungary for both sexes (48.1 male deaths per 100,000, 25.0 female deaths per 100,000); and the lowest rates are in Cyprus (11.4 male deaths per 100,000, 8.0 female deaths per 100,000) (Figure 2.5).7

Figure 2.5: Bowel Cancer including Anal Cancer (C18-C21), European Age-Standardised Mortality Rates, EU-27 Countries, 2008 Estimates

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UK bowel cancer (including anal cancer) mortality rates are 23rd (males) and joint 20th (females) highest in Europe (EU-27).

section reviewed 03/04/13
section updated 01/03/12

Male bowel cancer mortality rates are around 20% higher in the most deprived wards of England and Wales as compared with the least deprived wards,8 reflecting higher incidence in these groups.11 There is no obvious association with deprivation for females in England and Wales,8 or for either sex in Scotland and Northern Ireland.9,10

section reviewed 03/04/13
section updated 01/03/12