Bowel cancer incidence statistics

Bowel cancer is the 4th most common cancer in the UK, accounting for 11% of all new cancer cases (2016-2018).[1-4]

In females in the UK, bowel cancer is the 3rd most common cancer (10% of all new female cancer cases). In males in the UK, it is the 3rd most common cancer (12% of all new male cancer cases).

44% of bowel cancer cases in the UK are in females, and 56% are in males.

Bowel cancer incidence rates (European age-standardised (AS) rate ) for persons are significantly higher than the UK average in Scotland, Wales and Northern Ireland, and similar to the UK average in England.

For bowel cancer, like most cancer types, differences between countries largely reflect risk factor prevalence in years past.

Bowel Cancer (C18-C20), Average Number of New Cases Per Year, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2016-2018

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

Bowel cancer incidence is strongly related to age, with the highest incidence rates being in older people. In the UK in 2016-2018, on average each year more than 4 in 10 new cases (43%) were in people aged 75 and over.[1-4]

Age-specific incidence rates rise steeply from around age 50-54.The highest rates are in in the 85 to 89 age group for females and males.

Incidence rates are significantly lower in females than males in a number of (mainly older) age groups. The gap is widest at age 65 to 69, when the age-specific incidence rate is 1.7 times lower in females than males.

Bowel cancer (C18-C20), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, UK, 2016-2018

For bowel cancer, like most cancer types, incidence increases with age. The impact of routine screening on the age profile of bowel cancer is hard to discern, as bowel screening aims both to prevent and to diagnose early; these effects on the incidence trend may cancel one another out. The overall increase in incidence with age largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health.

Bowel cancer European age-standardised (AS) incidence rates for females and males combined remained stable in the UK between 1993-1995 and 2016-2018.[1-4] The decrease was of a similar size in females and males.

For females, bowel cancer AS incidence rates in the UK decreased by 2% between 1993-1995 and 2016-2018. For males, bowel cancer AS incidence rates in the UK decreased by 3% between 1993-1995 and 2016-2018.

Over the last decade in the UK (between 2006-2008 and 2016-2018), bowel cancer AS incidence rates for females and males combined decreased by 6%. In females AS incidence rates decreased by 4%, and in males rates decreased by 9%.

Bowel Cancer (C18-C20), European Age-Standardised Incidence Rates, UK, 1993 to 2018

Bowel cancer incidence rates have varied between age groups in females and males combined in the UK since the early 1990s.[1-4] Rates in 25-49s have increased by 48%, in 50-59s have remained stable, in 60-74s have decreased by 6%, in 75-79s have remained stable and in 80+s have remained stable.

Bowel Cancer (C18-C20), European Age-Standardised Incidence Rates per 100,000 Persons Population, By Age, UK, 1993-2018

For bowel cancer, like most cancer types, incidence trends largely reflect changing prevalence of risk factors and improvements in diagnosis and data recording. Recent incidence trends are influenced by risk factor prevalence in years past, and trends by age group reflect risk factor exposure in birth cohorts. The introduction of the bowel screening programmes in the mid-2000s probably also plays a part.

The largest proportion of bowel cancer cases occur in the rectum, with slightly smaller proportions in the sigmoid colon  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 incidence rates are projected to fall by 11% in the UK between 2014 and 2035, to 74 cases per 100,000 people by 2035.[1] This includes a larger decrease for males than for females.

For males, bowel cancer European age-standardised (AS) incidence rates in the UK are projected to fall by 15% between 2014 and 2035, to 87 cases per 100,000 by 2035.[1] For females, rates are projected to fall by 7% between 2014 and 2035, to 63 cases per 100,000 by 2035.[1]

Bowel cancer (C18-C20), Observed and Projected Age-Standardised Incidence Rates, by Sex, UK, 1979-2035

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It is projected that 53,646 cases of bowel cancer (29,356 in males, 24,290 in females) will be diagnosed in the UK in 2035.

Bowel cancer incidence rates (European age-standardised (AS) rates ) in England in females are similar in the most deprived quintile compared with the least, and in males are 9% higher in the most deprived quintile compared with the least (2013-2017).[1]

It is estimated that there are around 630 more cases of bowel cancer each year in males in England than there would be if every deprivation quintile had the same age-specific crude incidence rates as the least deprived quintile.

Bowel Cancer (C18-C20), Estimated Average Number of Excess Cases per Year and European Age-Standardised Incidence Rates per 100,000 Population, by Deprivation Quintile, England, 2013-2017

Age-standardised 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.

An estimated 230,200 people who had been diagnosed with bowel cancer between 1991 and 2010 were alive in the UK at the end of 2010.[1]