Colorectal cancer – third most common form of cancer

Colorectal cancer is the third most common form of cancer globally after lung- and breast cancer and the second most deadly. Despite several medical advances in cancer research, the mortality rate for metastatic colorectal cancer remains high – 86 percent of patients with disseminated disease die within five years.

Colorectal cancer is the collective name for colon and rectal cancer, a form of cancer that arises from uncontrolled cell growth in the colon or rectum. Colon cancer is equally common in men and women, while rectal cancer is slightly more common in men. Colorectal cancer mainly affects older people, with the majority developing the disease after the age of 70. However, the incidence is increasing in younger people (aged 25-49), while it is stable in older age groups. The global incidence (number of new patients diagnosed annually) for the cancer was just over 1.9 million patients in 2022, while approximately 0.9 million people died from the disease in the same year. Colorectal cancer usually occurs as uncontrolled cell division in the glands of the intestinal mucosa, which form polyps in the intestine that can develop into cancer after a while. When a cancerous tumor grows through the intestinal wall, the cancer cells can spread to other organs, so-called metastatic colorectal cancer, mCRC.

The causes are partly environmental and hereditary

As with most other cancers, there is no known single trigger for colorectal cancer. Hereditary factors and diet composition are considered to influence the risk. Smoking and lifestyles that cause obesity also increase the risk.

High mortality rate when detected late

Colorectal cancer is the second most common cause of cancer-related deaths globally after lung cancer. However, the prognosis for survival is good if diagnosed early. Through health checks, so-called screening, where blood is checked in the stool, colorectal cancer can be detected at an early stage, which reduces mortality. Patients who are detected at a late stage, when the cancer has spread to other organs and formed metastases, face a worse prognosis and a significantly higher mortality rate. Around 86 percent of patients with metastatic colorectal cancer, mCRC, are no longer alive five years after diagnosis.

Current standard of care

Today’s standard of care for metastatic colorectal cancer is based on 5-FU – one of the world’s most widely used cancer drugs – and is given in combination with both folate and other chemotherapy, such as oxaliplatin or irinotecan, as well as biological drugs such as bevacizumab and cetuximab. These combinations have been applied since 2004 and are variants of the current standard of care in first- and second-line. However, current folate-based drugs require metabolic activation that occurs in several steps. Despite combination treatment with several drugs, fewer than half of patients with metastatic colorectal cancer respond to treatment with current folate-based drugs. Immune and targeted therapy are also included in today’s standard of care for certain groups of patients who have specific mutations.

Metastatic cancer as initial focus for arfolitixorin

Colorectal cancer is classified into different stages based on tumor progression. In stage IV, when the cancer has metastasized beyond the intestine, surgery of the primary tumor is typically avoided as it does not improve the prognosis. At this stage, chemotherapy becomes the primary treatment, aimed at symptom relief and prolonging patient survival. Other therapeutic approaches are occasionally employed as well. While new drugs are being continually developed to enhance existing treatment combinations and improve clinical outcomes, 5-FU-based combination therapy is expected to remain the cornerstone of colorectal cancer treatment for the foreseeable future [source].Colorectal cancer is the collective name for colon and rectal cancer, a form of cancer that arises from uncontrolled cell growth in the colon or rectum. Colon cancer is equally common in men and women, while rectal cancer is slightly more common in men. Colorectal cancer mainly affects older people, with the majority developing the disease after the age of 70. The incidence in younger people (aged 25-49) is increasing, while it is stable in older age groups. The global incidence (number of new patients diagnosed annually) for the cancer was just over 1.9 million patients in 2022, while approximately 0.9 million people died from the disease in the same year. Colorectal cancer usually occurs as uncontrolled cell division in the glands of the intestinal mucosa, which form polyps in the intestine that can develop into cancer after a while. When a cancerous tumor grows through the intestinal wall, the cancer cells can spread to other organs, so-called metastatic colorectal cancer, mCRC.

Stages and treatment of colorectal cancer