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  • Primer
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Colorectal cancer

Abstract

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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Figure 1: Colorectal neoplasia at different stages.
Figure 2: The age-standardized incidence and mortality rates in men and women (per 100,000 people) across geographical zones.
Figure 3: The polyp to colorectal cancer sequences.
Figure 4: Surgical planes for right colon surgery.
Figure 5: Laparoscopic surgery for colorectal cancer.
Figure 6: Stoma surgery for colorectal cancer.
Figure 7: Surgical planes for rectal surgery.
Figure 8: Emerging drug targets and drug candidates in colorectal cancer.

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Introduction (E.J.K.); Epidemiology (T.W. and E.J.K.); Mechanisms/pathophysiology (W.M.G.); Diagnosis, screening and prevention (J.J.S., E.J.K. and D.L.); Management (P.G.B., C.J.H.v.d.V., T.S. and E.J.K.); Quality of life (E.J.K.); Outlook (All authors); Overview of the Primer (E.J.K.).

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Correspondence to Ernst J. Kuipers.

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T.S. has received honoraria for lectures or advisory boards from Roche, Merck-Serono, Amgen and Bayer. All other authors declare no competing interests.

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Kuipers, E., Grady, W., Lieberman, D. et al. Colorectal cancer. Nat Rev Dis Primers 1, 15065 (2015). https://doi.org/10.1038/nrdp.2015.65

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