Third most common cancer in the Western world.
Rare below 40 years of age.
Symptoms are not specific and occur frequently in benign colorectal conditions.
Surgical resection is the main curative treatment.
Combined modality treatment (chemotherapy, radiotherapy, resection of metastases) has increased survival in selected cases.
The majority of colorectal cancers are adenocarcinomas derived from epithelial cells. About 71% of new colorectal cancers arise in the colon and 29% in the rectum.  Less common types of malignant colorectal tumours are carcinoid tumours, GI stromal cell tumours, and lymphomas. Increasing age is the greatest risk factor for sporadic colorectal adenocarcinoma with 99% of cancers occurring in people aged 40 years or over.
Associate Dean Clinical Operations
Division of Colorectal Surgery
Drexel University College of Medicine
DES declares that he has no competing interests.
Dr David E. Stein would like to gratefully acknowledge Dr Najjia Mahmoud, Dr Emily Carter Paulson, Dr Gary Atkin, Dr Anne Ballinger, Dr Mark O'Hara, Dr Mark Harrison, and Dr Robert Glynne-Jones, previous contributors to this topic. NM, ECP, MOH, GA, and AB declare that they have no competing interests. MH is the chair of the Mount Vernon Upper GI Tumour Site Specific Group and a member of the National Cancer Research Institute anal, rectal, and advanced colorectal groups. He has also received honoraria for speaking and has been supported to attend international meetings in GI cancer from Roche. He has also received research funding from Pfizer for a trial in rectal cancer. RGJ is the chief medical adviser to the charity Bowel Cancer UK. He has received honoraria for lectures from Roche, Sanofi, and Pfizer. He has received funding for the EXTRA study, involving capecitabine and radiotherapy in anal cancer, published in the International Journal of Radiation Biology Physics. RGJ has also received funding and free cetuximab for an ongoing phase I/II study integrating cetuximab into chemoradiation in rectal cancer, and has an agreement from Roche to supply bevacizumab for 3 months to 60 patients in one randomised phase II study as neoadjuvant chemotherapy in rectal cancer (BACCHUS). He has also been supported by Roche to attend international meetings in GI cancer.
Consultant Colorectal Surgeon
St Mark's Hospital and Academic Institute
SC declares that she has no competing interests.
Chief of Staff
Department of Colorectal Surgery
SW declares that he has no competing interests.
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