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      Prevalence and risk factors of colorectal cancer in Asia

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          Abstract

          Globally, colorectal cancer (CRC) is a substantial public health burden, and it is increasingly affecting populations in Asian countries. The overall prevalence of CRC is reported to be low in Asia when compared with that in Western nations, yet it had the highest number of prevalent cases. This review described the prevalence of CRC in Asia according to the International Agency for Research on Cancer from World Health Organization (WHO) database and summarized its major risk factors. Non-modifiable factors include genetic factors, ethnicity, age, gender, family history and body height; smoking, alcohol drinking, weight, Westernized diet, physical inactivity, chronic diseases and microbiota were involved in environmental factors. These risk factors were separately discussed in this review according to published literature from Asian countries. CRC screening has been playing an important role in reducing its disease burden. Some recommendations on its screening practices have been formulated in guidelines for Asia Pacific countries.

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          Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors.

          Fatima Haggar, Robin P Boushey (2009)
          In this article, the incidence, mortality, and survival rates for colorectal cancer are reviewed, with attention paid to regional variations and changes over time. A concise overview of known risk factors associated with colorectal cancer is provided, including familial and hereditary factors, as well as environmental lifestyle-related risk factors such as physical inactivity, obesity, smoking, and alcohol consumption.
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            Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement.

            Kirsten Bibbins-Domingo, David Grossman, Susan Curry … (2016)
            Colorectal cancer is the second leading cause of cancer death in the United States. In 2016, an estimated 134,000 persons will be diagnosed with the disease, and about 49,000 will die from it. Colorectal cancer is most frequently diagnosed among adults aged 65 to 74 years; the median age at death from colorectal cancer is 68 years.
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              Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society

              Kevin C Oeffinger, Ya-Chen Tina Shih, Louise C Walter … (2018)
              In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model-recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation. The recommendation for regular screening in adults aged 50 years and older is a strong recommendation. The ACS recommends (qualified recommendations) that: 1) average-risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250-281. © 2018 American Cancer Society.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Intest Res
                Journal ID (iso-abbrev): Intest Res
                Journal ID (publisher-id): IR
                Title: Intestinal Research
                Publisher: Korean Association for the Study of Intestinal Diseases
                ISSN (Print): 1598-9100
                ISSN (Electronic): 2288-1956
                Publication date (Print): July 2019
                Publication date (Electronic): 20 May 2019
                Volume: 17
                Issue: 3
                Pages: 317-329
                Affiliations
                Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
                Author notes
                Correspondence to Martin CS Wong, Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong Special Administrative Region, China. Tel: +852-2252-8782, Fax: +852-2606-3500, E-mail: wong_martin@ 123456cuhk.edu.hk
                Author information
                http://orcid.org/0000-0001-7706-9370
                Article
                Publisher ID: ir-2019-00021
                DOI: 10.5217/ir.2019.00021
                PMC ID: 6667372
                PubMed ID: 31085968
                SO-VID: 6eea5e9b-ded5-48a7-8c62-f652fa12603f
                Copyright © © Copyright 2019. Korean Association for the Study of Intestinal Diseases. All rights reserved.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 5 March 2019
                Date revision received : 29 March 2019
                Date accepted : 1 April 2019
                Categories
                Subject: Review

                Keywords: colorectal neoplasms,epidemiology,risk,asia
                Data availability:
                Keywords: colorectal neoplasms, epidemiology, risk, asia

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