Colorectal cancer is the third most common cancer, after lung and breast cancer. During 1998, approximately 131,600 Americans were newly diagnosed with colorectal cancer, and 56,500 died of the disease. Cancer of the colon affects males and females with nearly equal frequency. One in 25 American adults develops colon cancer. Most patients diagnosed are 65 years of age or older.
As many as 600,000 individuals in the U.S. are under care following surgery for colorectal cancer. About half are at some risk for its recurrence, either due to a new primary tumor or metastatic disease undiscovered from a prior operation.
Increased risk. The greatest incidence of colorectal cancer seems to occur in the population with the highest incidence of diverticular disease (right). Diverticular disease is related to a high-lipid, high-carbohydrate diet and is likely mechanical. Evidence suggests that bacteria within the colon transform lipids into potentially carcinogenic substances. Low-bulk diets seem to lead to a greater retention of these potentially carcinogenic agents within the bowel lumen. Several genetic premalignant polyposis syndromes, including familial adenomatous polyposis (FAP), Turcot syndrome, and Gardner's syndrome, have been associated with a high risk of colorectal carcinoma.
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