Bowel cancer incidence statistics

Cases

New cases of bowel cancer, 2015, UK

 

Proportion of all cases

Percentage bowel cancer is of total cancer cases, 2015, UK

 

Age

Peak rate of bowel cancer cases, 2013-2015, 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 (2015).[1-4]

In males in the UK, bowel cancer is the 3rd most common cancer (13% of all new male cancer cases). In females in the UK it is the 3rd most common cancer (11% of all new female cancer cases).

55% of bowel cancer cases in the UK are in males, and 45% are in females.

Bowel cancer incidence rates (European age-standardised (AS) rates Open a glossary item ) are similar to the UK average in all the UK constituent countries.

Bowel Cancer (C18-C20), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2015

  England Scotland Wales Northern Ireland UK
Male Cases 19,178 1,989 1,278 637 23,082
Crude Rate 71.0 76.2 83.8 70.1 72.0
AS Rate 84.6 88.3 89.7 91.2 85.3
AS Rate - 95% LCI 83.4 84.4 84.8 84.1 84.2
AS Rate - 95% UCI 85.8 92.2 94.7 98.3 86.4
Female Cases 15,551 1,706 981 484 18,722
Crude Rate 56.0 61.8 62.3 51.4 56.7
AS Rate 56.8 60.1 57.3 57.0 57.2
AS Rate - 95% LCI 56.0 57.3 53.7 51.9 56.3
AS Rate - 95% UCI 57.7 63.0 60.9 62.1 58.0
Persons Cases 34,729 3,695 2,259 1,121 41,804
Crude Rate 63.4 68.8 72.9 60.5 64.2
AS Rate 69.4 72.4 71.8 72.6 69.9
AS Rate - 95% LCI 68.7 70.0 68.9 68.4 69.2
AS Rate - 95% UCI 70.2 74.7 74.8 76.9 70.6

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.

References

  1. Data were provided by the Office for National Statistics on request, July 2017. 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, August 2017. 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, October 2017. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, July 2017. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for UK, 2015, 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 2013-2015, on average each year more than 4 in 10 (44%) of 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 males and females.

Incidence rates are significantly higher in males than females in a number of (mainly older) age groups. The gap is widest at age 60 to 64, when the age-specific incidence rate is 1.7 times higher in males than females.

Bowel Cancer (C18-C20), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, UK, 2013-2015

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.

References

  1. Data were provided by the Office for National Statistics on request, July 2017. 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, August 2017. 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, October 2017. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, July 2017. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for UK, 2013-2015, ICD-10 C18-C20.

Last reviewed:

Bowel cancer European age-standardised (AS) Open a glossary item incidence rates for males and females combined increased by 1% in the UK between 1993-1995 and 2013-2015.[1-4] The change was of a similar size in males and females.

For males, bowel cancer AS incidence rates in the UK remained stable between 1993-1995 and 2013-2015. For females, bowel cancer AS incidence rates in the UK remained stable between 1993-1995 and 2013-2015.

Over the last decade in the UK (between 2003-2005 and 2013-2015), bowel cancer AS incidence rates for males and females combined remained stable. In males AS incidence rates decreased by 4%, and in females rates increased by 2%.

Bowel Cancer (C18-C20), European Age-Standardised Incidence Rates, UK, 1993-2015

Bowel cancer incidence rates have varied between age groups in males and females combined in the UK since the early 1990s.[1-4] Rates in 25-49s have increased by 33%, in 50-59s have remained stable, in 60-74s have decreased by 4%, in 75-79s have increased by 4%, and in 80+s have remained stable.

Bowel Cancer (C18-C20), European Age-Standardised Incidence Rates, By Age, UK, 1993-2015

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.

References

  1. Data were provided by the Office for National Statistics on request, July 2017. 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, August 2017. 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, October 2017. Similar data can be found here: http://www.wcisu.wales.nhs.uk.
  4. Data were provided by the Northern Ireland Cancer Registry on request, July 2017. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.

About this data

Data is for UK, 1993-2015, 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]

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

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]

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

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.

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]

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.

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:

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