Bowel cancer incidence statistics

Cases

New cases of bowel cancer, 2014-2016 average, UK

 

Proportion of all cases

Percentage bowel cancer is of total cancer cases, 2014-2016 average, UK

 

Age

Peak rate of bowel cancer cases, 2014-2016, UK

 

Trend over time

Bowel cancer incidence rates have remained stable since the early 1990s, UK

 

Bowel cancer is the 4th most common cancer in the UK, accounting for 12% of all new cancer cases (2016).[1-4]

In females in the UK it is the 3rd most common cancer (10% of all new female cancer cases). In males in the UK, bowel cancer is the 3rd most common cancer (13% 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) rates Open a glossary item) for persons are significantly higher than the UK average in Wales, and similar to the UK average in all other UK constituent countries.

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

  England Scotland Wales Northern Ireland UK
Female Cases 15,371 1,765 974 516 18,626
Crude Rate 55.0 63.6 61.7 54.5 56.0
AS Rate 55.4 61.9 56.3 59.7 56.2
AS Rate - 95% LCL 54.6 59.0 52.8 54.6 55.4
AS Rate - 95% UCL 56.3 64.8 59.9 64.9 57.0
Male Cases 19,581 1,961 1,363 624 23,529
Crude Rate 71.7 74.6 88.9 68.2 72.7
AS Rate 84.4 84.5 93.6 88.8 85.0
AS Rate - 95% LCL 83.2 80.8 88.6 81.8 83.9
AS Rate - 95% UCL 85.5 88.2 98.5 95.7 86.1
Persons Cases 34,952 3,726 2,337 1,140 42,155
Crude Rate 63.2 68.9 75.1 61.2 64.2
AS Rate 68.7 71.9 73.4 72.5 69.3
AS Rate - 95% LCL 68.0 69.6 70.4 68.3 68.7
AS Rate - 95% UCL 69.4 74.2 76.4 76.8 70.0

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
 

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

See also

Bowel cancer mortality statistics by sex and UK country

Bowel cancer incidence for common cancers in the UK

References

  1. Data were provided by the National Cancer Registration and Analysis Service (part of Public Health England), on request through the Office for Data Release, August 2018. Similar data can be found here: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancerregistrationstatisticsengland/previousReleases
  2. Data were provided by ISD Scotland on request, April 2018. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales on request, February 2019. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, April 2018. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for UK, 2016, ICD-10 C18-C20.

Last reviewed:

Bowel cancer incidence is strongly related to age, with the highest incidence rates being in older people. In the UK in 2014-2016, on average each year more than 4 in 10 (44%) new cases 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 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, 2014-2016

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
 

For bowel cancer, like other cancer types with a screening programme, incidence increases rapidly at the age screening starts, as prevalent cases are identified. Incidence then tends to return to the usual pattern of gradual increase with age, which 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.

See also

Bowel cancer mortality statistics by age

Bowel cancer survival statistics by age

Cancer incidence statistics by age for all cancers

References

  1. Data were provided by the National Cancer Registration and Analysis Service (part of Public Health England), on request through the Office for Data Release, August 2018. Similar data can be found here: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancerregistrationstatisticsengland/previousReleases
  2. Data were provided by ISD Scotland on request, April 2018. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales on request, February 2019. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, April 2018. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for UK, 2014-2016, ICD-10 C18-C20.

Last reviewed:

Bowel cancer European age-standardised (AS) Open a glossary item incidence rates for females and males combined remained stable in the UK between 1993-1995 and 2014-2016.[1-4] The rate remained stable in both females and males.

For females, bowel cancer AS incidence rates in the UK remained stable between 1993-1995 and 2014-2016. For males, bowel cancer AS incidence rates in the UK remained stable between 1993-1995 and 2014-2016.

Over the last decade in the UK (between 2004-2006 and 2014-2016), bowel cancer AS incidence rates for females and males combined decreased by 2%. In females AS incidence rates remained stable, and in males rates decreased by 5%.

Bowel Cancer (ICD-10 C18-C20), European Age-Standardised Incidence Rates, UK, 1993-2016

Bowel cancer incidence rates have remained stable overall in some broad adult age groups in females and males combined in the UK since the early 1990s, but have increased or decreased in others.[1-4] Rates in 25-49s have increased by 39%, in 50-59s have remained stable, in 60-74s have decreased by 5%, in 75-79s have remained stable, and in 80+s have remained stable.

Bowel Cancer (ICD-10 C18-C20), European Age-Standardised Incidence Rates, By Age, UK, 1993-2016

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.

See also

Bowel cancer mortality trends over time

Bowel cancer survival trends over time

Screening for bowel cancer

Cancer incidence trends over time for all cancers

References

  1. Data were provided by the National Cancer Registration and Analysis Service (part of Public Health England), on request through the Office for Data Release, August 2018. Similar data can be found here: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/cancerregistrationstatisticsengland/previousReleases
  2. Data were provided by ISD Scotland on request, April 2018. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit, Health Intelligence Division, Public Health Wales on request, February 2019. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, April 2018. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for UK, 1993-2016, ICD-10 C18-C20.

Last reviewed:

Overall stage at diagnosis

A high proportion (87-90%) of bowel cancer cases in England, Scotland and Northern Ireland have stage at diagnosis recorded.[1-3]

More bowel cancer patients with a known stage are diagnosed at a late stage (52-56% are diagnosed at stage III or IV), than an early stage (44-48% are diagnosed at stage I or II). Around 23-26% of bowel cancer patients have metastases at diagnosis (stage IV).[1-3]

The stage distribution for each cancer type will reflect many factors including how the cancer type develops, the way symptoms appear, public awareness of symptoms, how quickly a person goes to see their doctor and how quickly the cancer is recognised and diagnosed by a doctor. It might also relate to whether a national screening programme that can detect early stage disease exists for that cancer type, along with the extent of uptake of that programme.

A cancer type associated with a large proportion of early stage diagnoses could be one that is more likely to be symptomatic at an earlier stage of development, with recognisable symptoms rather than more generic ones.

Bowel Cancer (C18-C20), Proportion of Cases Diagnosed at Each Stage, All Ages, England 2014, Scotland 2014-15, and Northern Ireland 2010-2014

Data should not be compared between countries due to differences in time periods and possible differences in recording of stage at diagnosis.

Stage at diagnosis by deprivation

Late stage at diagnosis of bowel cancer in England is associated with higher deprivation. Among adults aged 15-99 in England, 57% of those in the most deprived areas are diagnosed at stage III or IV, versus 54% of those in the least deprived areas.[4]

Stage at diagnosis by age

Late stage at diagnosis of bowel cancer in England is more common in younger adults (aged 15-59) in England (61% diagnosed at stage III or IV), compared to older adults (aged 80+) (54% diagnosed at stage III or IV) and those aged 60-79 (53% diagnosed at stage III or IV).[4]

Stage at diagnosis by sex

Late stage at diagnosis of bowel cancer is not associated with sex in England.[4]

These patterns by deprivation, age and sex are probably not explained by other demographic differences.[5]

Stage at diagnosis by ethnicity

Late stage at diagnosis for bowel cancer in England is more common in Black Caribbean patients (54% diagnosed at stage III or IV), compared to White British patients (48% diagnosed at stage III or IV) after adjusting for age, sex and deprivation.[6]

See also

View our patient information on staging for bowel cancer

Bowel cancer survival by stage at diagnosis

More about incidence by stage data collection and quality

Routes to diagnosis

Deprivation gradient in bowel cancer incidence

References

  1. National Cancer Registration and Analysis Service. Stage Breakdown by CCG 2014. London: NCIN; 2016.
  2. ISD Scotland, Detect Cancer Early Staging Data. Scotland: ISD; 2016.
  3. Northern Ireland Cancer Registry, Queens University Belfast, Incidence by stage 2010-2014. Belfast: NICR; 2016.
  4. National Cancer Registration and Analysis Service. Routes to diagnosis of cancer by stage 2012-2013 workbook. London: NCRAS; 2016.
  5. Lyratzopoulos G, Abel G, Brown C, et al. Socio-demographic inequalities in stage of cancer diagnosis: evidence from patients with female breast, lung, colon, rectal, prostate, renal, bladder, melanoma, ovarian and endometrial cancer. Annals of Oncology, 2012:843-50.
  6. National Cancer Registration and Analysis Service. Ethnicity and stage at diagnosis. London: NCRAS; 2016.

About this data

Data is for: England 2014, Scotland 2014-2015, Northern Ireland 2010-2014, ICD-10 C18-C20 (overall stage at diagnosis) and England, 2012-2013, ICD-10 C18-C20 (stage at diagnosis by deprivation, age, sex, and ethnicity)

Data is not comparable between countries due to differences in time periods and possible differences in how countries record stage at diagnosis.

The proportions of patients diagnosed late only include cases with a known stage at diagnosis and are not adjusted for other demographics differences (e.g. age, sex, ethnicity) unless stated otherwise.

Last reviewed:

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]

Cases and percentages may not sum due to rounding

See also

Find out more about the counting and coding of this data

Bowel cancer morphology statistics

Bowel cancer incidence by sex statistics

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/.

About this data

Data is for UK, 2010-2012, ICD-10 C18-C20.

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]

See also

Find out more about the counting and coding of this data

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. 

About this data

See source for ICD codes and other data specifics

Last reviewed:

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) Open a glossary item 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

Download the data table (xls)

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.

See also

Find out how these projections were calculated

Incidence trends over time for bowel cancer 

Projections of incidence for all cancers combined

Bowel cancer risk

Download the projections data table

References

  1. Smittenaar CR, Petersen KA, Stewart K, Moitt N. Cancer Incidence and Mortality Projections in the UK Until 2035. Brit J Cancer 2016.

About this data

Data is for: UK, 1979-2014 (observed), 2015-2035 (projected), ICD-10 C18-C20

Projections are based on observed incidence and mortality rates and therefore implicitly include changes in cancer risk factors, diagnosis and treatment. It is not possible to assess the statistical significance of changes between 2014 (observed) and 2035 (projected) figures. Confidence intervals are not calculated for the projected figures. Projections are by their nature uncertain because unexpected events in future could change the trend. It is not sensible to calculate a boundary of uncertainty around these already uncertain point estimates. Changes are described as 'increase' or 'decrease' if there is any difference between the point estimates.

More on projections methodology

Last reviewed:

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]

See also

Deprivation gradient for cancer incidence

Deprivation gradient in bowel cancer incidence mortality

Bowel cancer survival statistics by socio-economic group

Socio-economic variation in cancer mortality for Scotland

Socio-economic variation in cancer mortality for Wales

Socio-economic variation in cancer mortality for Northern Ireland

References

  1. Cancer Research UK and National Cancer Intelligence Network. Cancer by deprivation in England: Incidence, 1996-2010, Mortality, 1997-2011. London: NCIN; 2014.  

About this data

Data is for UK, 2006-2010, ICD-10 C18-C20

Deprivation gradient statistics were calculated using incidence data for 2006-2010. The deprivation quintiles were calculated using the Income domain scores from the Index of Multiple Deprivation (IMD) from the following years: 2004, 2007 and 2010. Full details on the data and methodology can be found in the Cancer by Deprivation in England NCIN report.

Last reviewed:

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.

See also

Find out more about the counting and coding of this data

Cancer incidence statistics by ethnicity for all cancers in the UK

References

  1. National Cancer Intelligence Network (NCIN) and Cancer Research UK. Cancer Incidence and Survival by Major Ethnic Group, England, 2002-2006. London: NCIN; 2009.

About this data

Data is for UK, 2002-2006, ICD-10 C18-C20.

Last reviewed:

Cancer stats explained

See information and explanations on terminology used for statistics and reporting of cancer, and the methods used to calculate some of our statistics.

Cancer stats explained

Citation

You are welcome to reuse this Cancer Research UK content for your own work.
Credit us as authors by referencing Cancer Research UK as the primary source. Suggested styles are:

Web content: Cancer Research UK, full URL of the page, Accessed [month] [year].
Publications: Cancer Research UK ([year of publication]), Name of publication, Cancer Research UK.
Graphics (when reused unaltered): Credit: Cancer Research UK.
Graphics (when recreated with differences): Based on a graphic created by Cancer Research UK.

When Cancer Research UK material is used for commercial reasons, we encourage a donation to our life-saving research.
Send a cheque payable to Cancer Research UK to: Cancer Research UK, Angel Building, 407 St John Street, London, EC1V 4AD or

Donate online

We’re now on twitter.

Join the conversation and follow @TalkCancer_CRUK for news, updates and opinion.

@TalkCancer_CRUK

Acknowledgements

We are grateful to the many organisations across the UK which collect, analyse, and share the data which we use, and to the patients and public who consent for their data to be used. Find out more about the sources which are essential for our statistics.