TY - JOUR
T1 - Colorectal cancer
AU - Dekker, Evelien
AU - Tanis, Pieter J.
AU - Vleugels, Jasper L.A.
AU - Kasi, Pashtoon M.
AU - Wallace, Michael B.
N1 - Funding Information:
We identified articles for this Seminar by searches of MEDLINE, Embase, and Cochrane databases, and references from relevant articles, with various combinations of the search terms “adenoma”, colon cancer”, “colorectal cancer”, “colorectal neoplasms”, “colorectal tumor”, “chromosomal instability”, “diagnosis”, “drug therapy”, “epidemiology”, “genomic instability”, “microsatellite instability”, “molecular pathogenesis”, “morbidity”, “mortality”, “prevention”, “prognosis”, ”quality of life”, “radiotherapy”, “rectal cancer”, “risk factors”, “screening”, ”serrated neoplasia”, “surgery”, “survival”, and “therapy”. We excluded articles solely reported in the form of abstracts or meeting reports. We included articles published only in English between Jan 1, 1980, and May 31, 2019. Contributors All authors searched the literature and drafted specific sections of the Seminar: ED drafted the risk factors, pathophysiology, and secondary prevention sections. PT drafted the imaging, surgical therapy, radiotherapy for rectal cancer, and local treatment options for metastatic disease sections. JLAV drafted the sections on incidence and mortality, pathophysiology, quality of life during and after treatment, and primary and tertiary prevention sections. PMK drafted the sections on pathophysiology, diagnosis, and systemic treatment. MBW drafted the section on diagnosis and endoscopic management sections. ED and JLAV wrote the first full draft of the Seminar. All authors reviewed, edited, and agreed the submission of the final report. Declaration of interests ED reports grants, personal fees, and non-financial support from FujiFilm, and Olympus, a grant from Cancer Prevention Pharmaceuticals, and personal fees from Roche, Tillots, GI-Supply, outside the submitted work. PT reports personal fees from Johnson & Johnson, B Braun, Olympus, and Applied Medical, outside the submitted work, and grants from LifeCell, outside the submitted work. PMK reports grants from Taiho Oncology, Ipsen, Bristol-Myers Squibb, Advanced Accelerator Applications, Array BioPharma, and Celgene, outside the submitted work. MBW reports personal fees from Virgo, and grants from Boston Scientific, Medtronic, Ninepoint, and Cosmo Pharmaceuticals, outside the submitted work. JLAV declares no competing intrests. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations.
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/10/19
Y1 - 2019/10/19
N2 - Several decades ago, colorectal cancer was infrequently diagnosed. Nowadays, it is the world's fourth most deadly cancer with almost 900 000 deaths annually. Besides an ageing population and dietary habits of high-income countries, unfavourable risk factors such as obesity, lack of physical exercise, and smoking increase the risk of colorectal cancer. Advancements in pathophysiological understanding have increased the array of treatment options for local and advanced disease leading to individual treatment plans. Treatments include endoscopic and surgical local excision, downstaging preoperative radiotherapy and systemic therapy, extensive surgery for locoregional and metastatic disease, local ablative therapies for metastases, and palliative chemotherapy, targeted therapy, and immunotherapy. Although these new treatment options have doubled overall survival for advanced disease to 3 years, survival is still best for those with non-metastasised disease. As the disease only becomes symptomatic at an advanced stage, worldwide organised screening programmes are being implemented, which aim to increase early detection and reduce morbidity and mortality from colorectal cancer.
AB - Several decades ago, colorectal cancer was infrequently diagnosed. Nowadays, it is the world's fourth most deadly cancer with almost 900 000 deaths annually. Besides an ageing population and dietary habits of high-income countries, unfavourable risk factors such as obesity, lack of physical exercise, and smoking increase the risk of colorectal cancer. Advancements in pathophysiological understanding have increased the array of treatment options for local and advanced disease leading to individual treatment plans. Treatments include endoscopic and surgical local excision, downstaging preoperative radiotherapy and systemic therapy, extensive surgery for locoregional and metastatic disease, local ablative therapies for metastases, and palliative chemotherapy, targeted therapy, and immunotherapy. Although these new treatment options have doubled overall survival for advanced disease to 3 years, survival is still best for those with non-metastasised disease. As the disease only becomes symptomatic at an advanced stage, worldwide organised screening programmes are being implemented, which aim to increase early detection and reduce morbidity and mortality from colorectal cancer.
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U2 - 10.1016/S0140-6736(19)32319-0
DO - 10.1016/S0140-6736(19)32319-0
M3 - Review article
C2 - 31631858
AN - SCOPUS:85073506559
SN - 0140-6736
VL - 394
SP - 1467
EP - 1480
JO - The Lancet
JF - The Lancet
IS - 10207
ER -