Incidence and survival of colorectal cancer in the United Kingdom from 2000-2021: a population-based cohort study.

Background: The management of colorectal cancer (CRC) is evolving, with advances in screening and treatment.

Objective: To leverage population-based data to generate up-to-date UK estimates of age and sex-specific incidence and overall survival for the period 2000-2021.

Design: We analysed nationally representative primary care records from Clinical Practice Research Datalink (CPRD) GOLD and replicated in CPRD Aurum. We calculated incidence rates, and short- and long-term survival stratified by age, sex, and diagnosis year.

Results: Overall incidence was 67.4/100,000 person years, increasing in 2000-2011 to drop slightly in 2011-2014, and then plateauing. In contrast, early-onset CRC raised uninterruptedly throughout the study period, from 8.33 to 19.07/100,000 person-years.Overall survival was 78.3%, 51.4% and 38.5% at 1-, 5-, and 10-years respectively, lower in men compared to women. Modest improvements in survival were observed over the study period, particularly for 60-69-year-old patients.

Conclusion: Although the overall incidence in the population has plateaued, a worrying increasing trend of early-onset CRC was observed. Moreover, the slight improvement in overall survival suggests that significant progress is still needed. These findings highlight the urgent need for continued research and resource allocation to improve the diagnosis and management of colorectal cancer.