Testing and Colorectal cancer: Critical appraisal/ Epidemiology

Critical Appraisal
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Critical Appraisal
Epidemiology of Colorectal Cancer
In the United States (US), colorectal cancer is the third most common cancer and also the third leading cause of cancer-specific deaths (Centers for Disease Control and Prevention (CDC), 2020). The estimated new cases and deaths resulting from colorectal cancer in 2020 alone are 147, 950, and 53,200 respectively, according to the National Cancer Institute (2020). Colorectal cancer accounts for about 8% of the total new cases of cancer among men and women. It also accounts for about the same percentage of all cancer-specific deaths. However, the prevalence of colorectal cancer in the US has been on a gradual decline from 1992-2017, except for three consecutive years in 1996, 1997, and 1998 where it rose slightly and then started declining again (National Cancer Institute, 2020). The incidence rates among older adults have dropped to 3% per year. This decline has been attributed to increased screening, a decrease in colorectal cancer risk, and changes in the occurrence of colorectal cancer risk factors (Siegel, et al., 2017). Additionally, five-year survival rates have improved. The National Cancer Institute ( 2020) indicates that the five-year survival rate( from 2010-2016) was at 64.6%. While this decline is true for middle and older adults, the situation is different for younger adults. Siegel, et al. (2017) indicates that the incidence of colorectal cancer has, surprisingly, gone up among young adults. Also, despite the decline in prevalence rates, many men and women are still at the risk of developing colorectal cancer. It is estimated that about 4.2% of American men and women will, at some point in their life, be diagnosed with colorectal cancer (National Cancer Institute, 2020). The main risk factors for colorectal cancer are obesity, alcohol consumption, and tobacco smoking (Marley & Nan, 2016). Also, race, age, and certain genes predispose an individual to colorectal cancer.
Figure 1: Trends in New Cases and Death Rates, 1992-2017
Source: National Cancer Institute, 2020
Effects of Race, Age, Gender, and other Factors on the Epidemiology of Colorectal Cancer
Race determines the risk of colorectal cancer. People from certain racial backgrounds are more likely to develop colorectal cancer than others. According to the American Cancer Society (2017), the incidence rates among black Americans are approximately 20% higher than the rates among non-Hispanic whites. Also, non-Hispanic blacks have the highest incidence as well as death rates arising from colorectal cancer. Asians/Pacific Islanders have the lowest incidence and death rates. Age also increases the risk of colorectal cancer. The American Cancer Society (2017) reveals that the median age at the time of colon cancer diagnosis in men and women is 68 and 72 years, respectively. The median age for rectal cancer is the same for men and women, which is 63 years. However, the recent increase in the incidence rates of colorectal cancer among young adults suggests that the median age at diagnosis for the condition may be lower than 63 years. Further, men are at a higher risk of developing colorectal cancer than women. The incidence and death rates are...