[Prevention of colorectal cancer]

Cancer incidence in Spain, 2015

PURPOSE

Periodic cancer incidence estimates of Spain from all existing population-based cancer registries at any given time are required. The objective of this study was to present the current situation of cancer incidence in Spain.

METHODS

The Spanish Network of Cancer Registries (REDECAN) estimated the numbers of new cancer cases occurred in Spain in 2015 by applying the incidence-mortality ratios method. In the calculus, incidence data from population-based cancer registries and mortality data of all Spain were used.

RESULTS

In 2015, nearly a quarter of a million new invasive cancer cases were diagnosed in Spain, almost 149,000 in men (60.0%) and 99,000 in women. Globally, the five most common cancers were those of colon-rectum, prostate, lung, breast and urinary bladder. By gender, the four most common cancers in men were those of prostate (22.4%), colon-rectum (16.6%), lung (15.1%) and urinary bladder (11.7%). In women, the most common ones were those of breast (28.0%), colon-rectum (16.9%), corpus uteri (6.2%) and lung (6.0%). In recent years, cancer incidence in men seems to have stabilized due to the fact that the decrease in tobacco-related cancers compensates for the increase in other types of cancer like those of colon and prostate. In women, despite the stabilization of breast cancer incidence, increased incidence is due, above all, to the rise of colorectal and tobacco-related cancers.

CONCLUSION

To reduce these incident cancer cases, improvement of smoking control policies and extension of colorectal cancer screening should be the two priorities in cancer prevention for the next years.

Need to implement a coordinated and multidisciplinary care in the Spanish population at increased risk for colorectal cancer

Colorectal cancer (CRC) is the second leading cause of cancer death in most developed countries and the most prevalent malignancy when considering men and women together. From a practical standpoint, the individual probability of developing CRC is divided in average risk, which corresponds to individuals aged ≥50 years without additional risk factors (susceptible to population-based screening measures), and high risk, which corresponds to those individuals with any risk factor (hereditary syndromes, personal history and/or family history of adenomas or CRC). This group requires a specific, specialized, and multidisciplinary evaluation in high-risk units. Despite the evidence that screening and surveillance in high-risk forms of CRC is highly effective preventing CRC-deaths, underdiagnosis and lack of application of preventive measures in this population remain the main challenges. The Alliance for Colon Cancer Prevention, an organization that brings together the majority of scientific societies and associations involved in the prevention of this disease in Spain, has gathered a group of experts in various fields involved in the management of patients with CRC. These experts have integrated a discussion forum evaluating the current status and needs in relation to the care of people with an increased risk of CRC in Spain. This document is intended to bring consensus of all involved professionals with the only hope of improving the care of population at risk for CRC.