Incidence, prevalence, 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. We leveraged population-based data to generate up-to-date UK estimates of age and sex-specific incidence and prevalence and overall survival for the period 2000-2021. Methods: We analysed nationally representative primary care records from Clinical Practice Research Datalink (CPRD) GOLD, and replicated in CPRD Aurum. We calculated incidence rates, prevalence, and short- and long-term survival stratified by age, sex, and diagnosis year. Results: Unadjusted prevalence increased in the study period, from 15.6 to 46.4/10,000. Overall incidence was 61.5/100,000 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: The overall prevalence of CRC in the UK has tripled in the last 20 years, leading to increased healthcare resource needs and with slight survival improvements. A worrying increasing trend of early-onset CRC is observed, warranting further research into its diagnosis and management.