Book contents
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- 25 Esophagus
- 26 Stomach
- 27 Small intestine
- 28 Large intestine: colon and rectum
- 29 Liver
- 30 Gall bladder and extrahepatic biliary ducts
- 31 Pancreas
- PART VII Respiratory system
- PART VIII Bone and soft tissue
- PART IX Skin
- PART X Breast and genitourinary system
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
28 - Large intestine: colon and rectum
Published online by Cambridge University Press: 03 May 2010
- Frontmatter
- Contents
- Contributors
- Preface
- Acknowledgements
- Historical introduction
- PART I Epidemiological methods
- PART II Causative factors in human cancer
- PART III Legal and ethical considerations
- PART IV Introduction: total and specific site epidemiology
- PART V Buccal cavity
- PART VI Digestive system
- 25 Esophagus
- 26 Stomach
- 27 Small intestine
- 28 Large intestine: colon and rectum
- 29 Liver
- 30 Gall bladder and extrahepatic biliary ducts
- 31 Pancreas
- PART VII Respiratory system
- PART VIII Bone and soft tissue
- PART IX Skin
- PART X Breast and genitourinary system
- PART XI Eye and nervous system
- PART XII Thyroid and other endocrine glands, lymphoid and hematopoietic system
- PART XIII Cancers in children and multiple primary cancers
- Conclusions
- Appendix 1 Cancer statistics
- Appendix 2 A glossary of epidemiological terms
- Appendix 3 Acronyms and abbreviations
- Supplement
- Index
Summary
Introduction
While cancers of the colon and rectum show some differences in their geographic and temporal distribution, it is usual to discuss them together in terms of causation.
Histology, classification and diagnosis
Epithelial tumors of the colorectum are adenocarcinomas. In many patients, such cancers are frequently associated with benign polyps and adenomas as well as dysplastic mucosal lesions which are believed to be precancerous (Ponz de Leon et al., 1987).
Geographic differences have been observed in the distribution by subsite (Schottenfeld & Winawer, 1982). Unfortunately, the anatomical boundary around the recto-sigmoid (which for international classification purposes is assigned to the rectum), is variable and the terms sigmoid and recto-sigmoid are often used interchangeably by clinicians. De Jong et al., (1972) concluded, however, that this made little difference to incidence rates. Non-epithelial tumors are discussed in Chapter 37.
Descriptive epidemiology
Incidence
For colon cancer, the highest male incidence rates are in the white population of Connecticut, USA (34.1). The highest female rate (29.0) is in the black population of Detroit (Fig. 28.1). Rates, in the range of 15 to 20, are observed in Canada and much of western Europe. In western Europe, the incidence tends to be more than twice that east of the Elbe River. In Asia and Latin America, rates are low to intermediate (10 to 15).
- Type
- Chapter
- Information
- Human CancerEpidemiology and Environmental Causes, pp. 286 - 295Publisher: Cambridge University PressPrint publication year: 1992
- 1
- Cited by