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Nat Rev Dis Primers. 2015 Nov 5;1:15065. doi: 10.1038/nrdp.2015.65.

Colorectal cancer.

Author information

Erasmus MC University Medical Center, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Department of Medicine, University of Washington School of Medicine, Seattle, Washington, USA.
Division of Gastroenterology and Hepatology, Oregon Health and Science University, Portland, Oregon, USA.
Department of Internal Medicine I, University of Ulm, Ulm, Germany.
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China.
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Department of Surgical Oncology and Vascular Surgery, University of Tokyo and the University of Tokyo Hospital, Tokyo, Japan.


Colorectal cancer had a low incidence several decades ago. However, it has become a predominant cancer and now accounts for approximately 10% of cancer-related mortality in western countries. The 'rise' of colorectal cancer in developed countries can be attributed to the increasingly ageing population, unfavourable modern dietary habits and an increase in risk factors, such as smoking, low physical exercise and obesity. New treatments for primary and metastatic colorectal cancer have emerged, providing additional options for patients; these treatments include laparoscopic surgery for primary disease, more-aggressive resection of metastatic disease (such as liver and pulmonary metastases), radiotherapy for rectal cancer, and neoadjuvant and palliative chemotherapies. However, these new treatment options have had limited impact on cure rates and long-term survival. For these reasons, and the recognition that colorectal cancer is long preceded by a polypoid precursor, screening programmes have gained momentum. This Primer provides an overview of the current state of the art of knowledge on the epidemiology and mechanisms of colorectal cancer, as well as on diagnosis and treatment.

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