Screening for colorectal cancer

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The large bowel is world-wide the fourth commonest site for cancer after lung, stomach and breast and the fourth cause of cancer death after lung, stomach and liver cancer. There were 943,000 new cases diagnosed and 510,000 large bowel cancer deaths in 2000 (Parkin et al. 2001). Highest incidence rates occur in North America, Northern Europe and Australasia where the disease ranks second after lung cancer. Lowest rates are found in sub-Saharan Africa and India. There have been marked increases in incidence rates in Asian populations adopting a Western lifestyle, such as the Chinese of Shangai and Hong Kong, Singaporeans and Japanese, and in Eastern Europe (Coleman et al. 1993).