Colorectal cancer is the world’s fourth most deadly cancer, killing almost 700,000 people every year. And it is expected to become more common as more people adopt Western diets and lifestyles, which are implicated as risk factors. But research into screening, prevention and treatments is helping to fight the disease. Cover Art: Mario Wagner
Nature Outlook: Colorectal cancer
【LWBS 2015 05 19 A】(SpringRain edited from Nature/Herb Brody) Colorectal cancer (CRC) kills almost 700,000 people every year, making it the world's fourth most deadly cancer (after lung, liver and stomach cancer). It is a disease of modernity: the highest rates of incidence are in developed countries (A disease of growth). As the world becomes richer, and more people shift to Western diets and lifestyles, the incidence of CRC is likely to increase.
But there is encouraging news. Screening for the disease has become routine in many parts of the world, and newer, less invasive technologies are being developed to replace the highly invasive colonoscopy (Screening: Early alert). And evidence is mounting that the disease could be largely prevented by a combination of drugs, nutritional supplements, diet and exercise (Prevention: Tending the gut).
There is encouraging research on several fronts. The development of three-dimensional 'organoids' derived from adult stem cells could help match drugs to a patient's specific tumour type (Q&A: Hans Clevers). And DNA fragments that have escaped from tumours into the blood could be detected in 'liquid biopsies' that can characterize the tumour and help monitor the effectiveness of treatments (Q&A: Victor Velculescu).
On the therapeutic front, however, progress is a matter of inches. New drugs have roughly doubled the average survival time for advanced CRC over the past decade, but the patient usually dies within three years (Drug development: Mix and match).
As with many other diseases, scientists are finding that the organisms that live inside us play a big role (Microbiome: Microbial mystery). But whether an abnormal microbiome is a cause of CRC or an effect is still shrouded in mystery. This is just one of several fundamental questions about the disease that remain to be resolved (Colorectal cancer: 5 big questions).
Colorectal cancer is a disease of development. Across the globe, as economies grow, so too does the incidence of colorectal cancer. Lifestyle changes are to blame, and in this Nature Video we see how increases in colorectal cancer are affecting many countries around the world, and what this could mean in the future to a world that is still developing.