Bowel cancer incidence statistics

Cases

New cases of bowel cancer, 2013, UK

 

Proportion of all cases

Percentage bowel cancer is of total cancer cases, 2013, UK

 

Age

Age that almost 6 in 10 of bowel cancer cases are diagnosed, 2011-2013, UK

 

Trend since 1970s

Bowel cancer incidence rates have increased since the late 1970s, GB

 

Bowel cancer is the fourth most common cancer in the UK (2013), accounting for 12% of all new cases. It is the third most common cancer in both males (13% of the male total) and females (11%) separately.[1-4]

In 2013, there were 41,112 new cases of bowel cancer in the UK: 22,957 (56%) in men and 18,155 (44%) in women, giving a male:female ratio of 13:10.[1-4] The crude incidence rate Open a glossary item shows that there are 73 new bowel cancer cases for every 100,000 males in the UK and 56 for every 100,000 females.[1-4]

The European age-standardised incidence rates Open a glossary item (AS rates) are significantly lower in England compared with Wales, Scotland and Northern Ireland for males.[1-4] For females, the rates are significantly lower in England and Wales compared with Scotland and Northern Ireland. Rates do not differ significantly between the other constituent countries of the UK for either sex.[1-4]

Bowel Cancer (C18-C20), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2013

England Wales Scotland Northern Ireland UK
Male Cases 18,839 1,336 2,114 668 22,957
Crude Rate 71.0 88.2 81.7 74.5 72.8
AS Rate 86.8 96.2 96.0 100.1 88.4
AS Rate - 95% LCL 85.5 91.1 91.9 92.5 87.3
AS Rate - 95% UCL 88.0 101.4 100.1 107.7 89.6
Female Cases 14,926 936 1,735 558 18,155
Crude Rate 54.6 59.7 63.3 59.8 55.7
AS Rate 56.2 56.1 62.9 67.3 57.1
AS Rate - 95% LCL 55.3 52.5 59.9 61.7 56.2
AS Rate - 95% UCL 57.1 59.7 65.9 72.9 57.9
Persons Cases 33,765 2,272 3,849 1,226 41,112
Crude Rate 62.7 73.7 72.2 67.0 64.1
AS Rate 70.0 74.4 77.5 82.4 71.2
AS Rate - 95% LCL 69.2 71.4 75.0 77.8 70.5
AS Rate - 95% UCL 70.7 77.5 79.9 87.0 71.9

95% LCL and 95% UCL are the 95% lower and upper confidence limits Open a glossary item around the AS Rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

The highest incidence rates are in Scotland, Northern Ireland and the north of England for males and in the east and south-west England for females.[5]

References

  1. Data were provided by the Office for National Statistics on request, July 2015. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2015. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, February 2015. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242pid=59080
  4. Data were provided by the Northern Ireland Cancer Registry on request, March 2015. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
  5. National Cancer Intelligence Network. Cancer e-atlas. Accessed January 2012. 
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Bowel cancer incidence is strongly related to age, with the highest incidence rates being in older males and females. In the UK in 2011-2013, on average each year almost 6 in 10 (58%) cases were diagnosed in people aged 70 and over. 

Age-specific incidence rates increase sharply from around age 50-54, with the highest rates in the 85-89 age group for both males and females. Incidence rates are significantly higher for males than females in those aged aged 45-49 and over and this gap is widest at age 65-69, when the male:female ratio of age-specific incidence rates (to account for the different proportions of males to females in each age group) is around 17:10.[1-4]

Bowel Cancer (C18-C20), Average Number of New Cases Per Year and Age-Specific Incidence Rates, UK, 2011-2013

The age distribution of bowel cancer cases largely reflects the age groups eligible for bowel screening in the UK.

References

  1. Data were provided by the Office for National Statistics on request, July 2015. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2015. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, February 2015. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
  4. Data were provided by the Northern Ireland Cancer Registry on request, March 2015. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
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Bowel cancer incidence rates have increased by 14% in Great Britain since the late 1970s.[1-3] This includes a larger increase for males than for females.

For males, European age-standardised (AS) Open a glossary item incidence rates have increased by 19% between 1979-1981 and 2011-2013. For females, the rise is smaller, with rates increasing by 3% between 1979-1981 and 2011-2013.[1-3]

Bowel Cancer (C18-20), European Age-Standardised Incidence Rates, Great Britain, 1979-2013

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Over the last decade in the UK (between 2002-2004 and 2011-2013), bowel cancer AS incidence rates have increased by 5% for males and females combined, and by 3% and 6% for males and females respectively.[1-4]

Bowel Cancer (C18-20), European Age-Standardised Incidence Rates, UK, 1993-2013

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

Bowel cancer incidence trends probably reflect changing prevalence of risk factors, with recent incidence trends influenced by risk factor prevalence in years past. The introduction of the bowel screening programmes in the mid-2000s probably also plays a part.[5]

Bowel cancer incidence rates increased for all of the broad age groups in Great Britain since the late 1970s.[1-3] The largest increase has been in people aged 60-69, with European AS incidence rates increasing by 22% between 1979-1981 and 2011-2013.[1-3]

Bowel Cancer (C18-20), European Age-Standardised Incidence Rates, By Age, Great Britain, 1979-2013

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/search/index.html?newquery=cancer+registrations
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242pid=59080
  4. Jones AM, Morris E, Thomas J, et al. Evaluation of bowel cancer registration data in England, 1996-2004. Br J Cancer 2009;101(8):1269-73.
  5. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/
  6. NHS Screening Programme
  7. Scottish Bowel Screening Programme
  8. Bowel Screening Wales
  9. Northern Ireland Bowel Screening Programme
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Staging completeness for bowel cancer is moderate in England, with 82% of bowel cancers recorded with a known stage at diagnosis in 2013.[1]

Bowel Cancer (C18-C20), Proportion of Cases Diagnosed at Each Stage, England 2013

More people with a known stage are diagnosed at a late stage (55% diagnosed at stage III or IV), than an early stage (45% diagnosed at stage I or II). Around a quarter (26%) of people have metastases Open a glossary item at diagnosis (stage IV).[1]

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The lifetime risk of developing bowel cancer is 1 in 14 for men and 1 in 19 for women, in 2012 in the UK.[1]

The lifetime risk for bowel cancer has been calculated to account for the possibility that someone can have more than one diagnosis of bowel  cancer over the course of their lifetime (‘Adjusted for Multiple Primaries’ (AMP) method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Sasieni PD, Shelton J, Ormiston-Smith N, et al. What is the lifetime risk of developing cancer?: The effect of adjusting for multiple primaries. Br J Cancer, 2011. 105(3): p. 460-5.
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The largest proportion of bowel cancer cases occur in the rectum, with slightly smaller proportions in the sigmoid colon Open a glossary item and caecum, and a much smaller proportion in the ascending colon (2010-2012).[1-4]

The proportions of cases in the rectum and sigmoid colon are higher in males (31.5% and 23.1%, respectively) than females (23.1% and 20.4%, respectively). In the caecum and ascending colon, the proportions are higher in females (17.2% and 9.8%, respectively) than males (12.2% and 7.3%, respectively), and there are no marked sex differences in other parts of the bowel.[1-4]

A small proportion of cases did not have the specific part of the colon recorded in cancer registry data, or overlapped more than one part.[1-4]

Bowel Cancer (C18-C20), Percentage Distribution of Cases Diagnosed By Anatomical Site, by Sex, UK, 2010-2012

Cases and percentages may not sum due to rounding

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here:
    http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:
    http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerInformation/.
Last reviewed:

More than 90% of bowel cancer cases are adenocarcinomas[glossary - adenocarcinomas] and the majority of these arise from adenomatous polyps (adenomas ). These common benign tumours develop from normal colonic mucosa and are present in about a third of the European and USA populations.[1]

The more difficult to detect flat adenomas account for about 10% of all lesions Open a glossary item and may have a greater propensity to malignant change.[2,3]

Only a small proportion of polyps (1-10%) develop into invasive bowel cancer.[4] Indicators for progression from adenomas to cancer include large size, villous histology and severe dysplasia Open a glossary item.[5]

References

  1. Midgley R, Kerr D. Colorectal cancer. Lancet 1999;353:391-399. 
  2. Hardy R, Meltzer S, Jankowski J. ABC of colorectal cancer: Molecular basis for risk factors. BMJ 2000;321:886-889.
  3. O'Brien MJ, Winawer SJ, Zauber AJ, et al. Flat adenomas in the National Polyp Study: is there increased risk for high grade dysplasia initially or during surveillance. BMJ 2000;321:886-889.
  4. Scholefield J. ABC of colorectal cancer: Screening. BMJ 2000;321:1004-1006. 
  5. Terry MB, Neugut AI, Bostick RM, et al. Risk factors for advanced colorectal adenomas: A pooled analysis. Cancer Epidemiol Biomarkers Prev 2002;11:622-629. 
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Bowel cancer (C18-C21) is the second most common cancer in Europe, with around 447,000 new cases diagnosed in 2012 (13% of the total). In Europe (2012), the highest World age-standardised Open a glossary item incidence rates for bowel cancer are in Slovakia for men and Norway for women; the lowest rates are in Albania for both men and women. UK bowel cancer incidence rates are estimated to be the 20th highest in males in Europe, and 17th highest in females.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Bowel cancer (C18-C21) is the third most common cancer worldwide, with more than 1,360,000 new cases diagnosed in 2012 (10% of the total). Bowel cancer incidence rates are highest in Australia/New Zealand and lowest in Western Africa, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect different prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed December 2013.
  2. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403. 
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There is evidence for a small association between bowel cancer incidence and deprivation for males in England, while there is no evidence for an association for females.[1] England-wide data for 2006-2010 show European age-standardised Open a glossary item incidence rates are 13% higher for males living in the most deprived areas compared with the least deprived, while for females the rates are similar for those living in the least and most deprived areas.[1]

Bowel Cancer (C18-C20), European Age-Standardised Incidence Rates by Deprivation Quintile, England, 2006-2010

The estimated deprivation gradient in bowel cancer incidence for males and females living in the most and least deprived areas in England has not changed in the period 1996-2010. It has been estimated that there would have been around 770 fewer bowel cancer cases each year in England during 2006-2010 if all people experienced the same incidence rates as the least deprived.[1]

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Age-standardised Open a glossary item rates for White males with bowel cancer range from 54.1 to 55.3 per 100,000. Rates for Asian males are significantly lower, ranging from 19.1 to 28.0 per 100,000 and the rates for Black males are also significantly lower, ranging from 29.7 to 43.8 per 100,000. For females there is a similar pattern - the age-standardised rates for White females range from 34.0 to 34.8 per 100,000, and rates for Asian and Black females are also significantly lower ranging from 11.3 to 17.5 per 100,000 and 20.4 to 31.6 per 100,000 respectively.[1]

Ranges are given because of the analysis methodology used to account for missing and unknown data. For bowel cancer, 146,495 cases were identified; 17% had no known ethnicity.

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In the UK more than 143,000 people were still alive at the end of 2006, up to ten years after being diagnosed with bowel cancer.[1]

Bowel Cancer (C18-C20), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Male 14,635 51,183 78,483
Female 11,415 40,594 65,075
Persons 26,050 91,777 143,558

Worldwide, it is estimated that there were around 3.26 million men and women still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, five and ten-year cancer prevalence by cancer network, UK, 2006. London: NCIN; 2010. 
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr. Accessed May 2011. 
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Cancer Statistics Explained

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