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ERBITUX Project Metastatic colorectal carcinoma

Endoscopic examination of colorectal carcinoma.
(Source: Wikipedia)

Gross appearance of a colectomy specimen containing one invasive colorectal carcinoma.
(Zdroj: Wikipedia)

There has been a significant progress in the diagnosis and treatment of colorectal cancer. The disease has been understood on the molecular basis, new treatment options and screening strategies have been adopted – all these factors have had a positive influence on disease progression and patient's prognosis.

The colorectal cancer presents an important medical and economic issue, worrying patients, health care providers, and the society as a whole.

Colorectal carcinoma is the third most common cancer worldwide: the incidence (i.e., number of new cases) in 2000 has reached 944 717. Colorectal cancer accounts for about 10% of all diagnosed malignities. In Western Europe, colorectal cancer is the third most common type of cancer in men (after lung cancer and prostate cancer), and the second most common type of cancer in women (after breast cancer). In the United States, colorectal cancer is the third most common type of cancer in both men (after prostate cancer and lung cancer) and women (after breast cancer and lung cancer). The mortality caused by colorectal cancer is estimated to be 450,000 deaths per year [1,2].

During the period of 2002-2010, the incidence of colorectal cancer is expected to grow by approximately 14% in seven developed countries (Japan, Germany, Span, United Kingdom, Italy and USA).

Colorectal cancer is one of the most common cancer types in the Czech Republic [3]; at the European level, we have the highest incidence of colorectal cancer in men, and the second highest incidence in women. Colorectal cancer is the leading cause of cancer deaths in the Czech Republic. Over the last 20 years, the incidence of colorectal cancer has risen by 190%. Every year, there are about 7450 newly-diagnosed cases of colorectal cancer in the Czech Republic, and 4400 patients die of the disease. In 2001, there were 30 600 colorectal cancer patients living in the Czech Republic [3].

Those people who have not undergone a screening examination have a 0.5-2.0% probability of developing an invasive colorectal carcinoma, 1.0-1.6% probability of developing a carcinoma in situ, 1-6% probability of developing a large (1 cm or more) adenoma and 25-40% probability of developing an adenoma of any size.

From all demographic factors, age plays the most important role in the incidence of colorectal cancer. A sporadic incidence of colorectal cancer increases dramatically after 45-50 years of age. In most countries, the incidence of colorectal cancer is observed to be lower in women than men in all age categories. As for the Czech Republic, the colorectal cancer affects mostly the population aged over 50, with a slight predominance of men.

The diagnosis is often established too late, as the early stages of colorectal cancer are usually asymptomatic. As a result, about 25% of cases are diagnosed in advanced stages with metastases; in 40-50% of newly diagnosed patients with earlier stages of disease, metastases develop over time. The five-year survival in patients with metastatic disease is very low, just about 3%.

Epidemiology of colorectal carcinoma in the Czech Republic

Click on the images to enlarge them.
(Source: www.svod.cz [3])

Malignant neoplasms of colon and rectum (C18-C21)

Time trends in incidence and mortality. Comparison of incidence among individual Czech regions.
Age structure of patients. Comparison of incidence in the Czech Republic and abroad.


  1. Pecen, Topolčan O, Koukalová H et al. Epidemiology of colorectal carcinoma in the Czech Republic. J Tumor Marker Oncology, 2000, 15(1), 55:56
  2. Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999;49:33.
  3. Dušek, L., Mužík, J., Kubásek, M., Koptíková, J., Žaloudík, J., Vyzula, R.: Epidemiologie zhoubných nádorů v České republice [online]. Masarykova univerzita, Brno, 2005. Dostupný z WWW: http://www.svod.cz. ISSN 1802-8861

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