Are There Risk Factors in the European Population, Which Promote Rectal Cancer and/or Favour Curability?

  • Josep M. Borras
  • Amanda C. R. K. Bos
  • Antoni Castells


Although the survival of rectal cancer has steadily improved in recent years [1], differences in the distribution of cases by stage at diagnosis and in survival within each stage strongly indicate that there are opportunities to improve outcomes if we are able to apply that what we know is effective. Challenges posed by the ageing of the population and its impact on the comorbidity at diagnosis are factors with strong influence on the therapeutic decision-making. Rectal cancer is also associated with hereditary syndromes that could modify significantly the therapeutic approach and, as a consequence, patients’ prognosis.


  1. 1.
    Brenner H, Bouvier A, Foschi V et al (2012) Progress in colorectal cancer survival in Europe from the late 1980s to the early 21st century: the EUROCARE study. Int J Cancer 131:1649–1658CrossRefPubMedGoogle Scholar
  2. 2.
    Maringe C, Walters S, Rachet B et al (2013) Stage at diagnosis and colorectal cancer survival in six high-income countries: a population-based study of patients diagnosed during 2000-2007. Acta Oncol 52:919–932CrossRefPubMedGoogle Scholar
  3. 3.
    Liu L, Lemmens V, de Hingh IH et al (2013) Second primary cancers in subsites of colon and rectum in patients with previous colorectal cancer. Dis Colon Rectum 56:158–163CrossRefPubMedGoogle Scholar
  4. 4.
    Continuous Update Project (2011) Colorectal cancer report, 2011: food, nutrition, physical activity and the prevention of colorectal cancer. World Cancer Research Fund/American Institute for Cancer Research, WashingtonGoogle Scholar
  5. 5.
    Romaguera D, Ward H, Wark P et al (2015) Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients. BMC Med 13:107CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Chan AT, Arber N, Burn J et al (2012) Aspirin in the chemoprevention of colorectal neoplasia: an overview. Cancer Prev Res 5:164–178CrossRefGoogle Scholar
  7. 7.
    Lemmens VEPP, Jansen-Heijnen MLG, Verweij CDGW et al (2005) Co-morbidity leads to altered treatment and worse survival of elderly patients with colorectal cancer. Br J Surg 92:615–623CrossRefPubMedGoogle Scholar
  8. 8.
    von Karsa L, Patnik J, Segnan N et al (2013) European guidelines for quality assurance in colorectal cancer screening and diagnosis: overview and introduction to the full supplement publication. Endoscopy 45:51–59CrossRefGoogle Scholar
  9. 9.
    Brenner H, Hoffmeister M, Arndt V et al (2010) Protection from right and left-hand sided colorectal neoplasms after colonoscopy: population based study. Ann Intern Med 102:89–95Google Scholar
  10. 10.
    Vasen HF, Tomlinson I, Castells A (2015) Clinical management of hereditary colorectal cancer syndromes. Nat Rev Gastroenterol Hepatol 12:88–97CrossRefPubMedGoogle Scholar
  11. 11.
    Moreira L, Pellise M, Carballal S et al (2013) High prevalence of serrated polyposis syndrome in FIT-based colorectal cancer screening programmes. Gut 62:476–477CrossRefPubMedGoogle Scholar
  12. 12.
    de la Chapelle A (2005) The incidence of lynch syndrome. Familial Cancer 4:233–237CrossRefPubMedGoogle Scholar
  13. 13.
    Lee JS, Petrelli NJ, Rodriguez-Bigas MA (2001) Rectal cancer in hereditary nonpolyposis colorectal cancer. Am J Surg 181:207–210CrossRefPubMedGoogle Scholar
  14. 14.
    Vasen HF, Wijnen JT, Menko FH et al (1996) Cancer risk in families with hereditary nonpolyposis colorectal cancer diagnosed by mutation analysis. Gastroenterology 110:1020–1027CrossRefPubMedGoogle Scholar
  15. 15.
    Maeda T, Cannom RR, Beart RW Jr, Etzioni DA (2010) Decision model of segmental compared with total abdominal colectomy for colon cancer in hereditary nonpolyposis colorectal cancer. J Clin Oncol 28:1175–1180CrossRefPubMedGoogle Scholar
  16. 16.
    Rodriguez-Bigas MA, Vasen HF, Pekka-Mecklin J et al (1997) Rectal cancer risk in hereditary nonpolyposis colorectal cancer after abdominal colectomy. International collaborative group on HNPCC. Ann Surg 225:202–207CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Jover R, Nguyen TP, Perez-Carbonell L et al (2011) 5-fluorouracil adjuvant chemotherapy does not increase survival in patients with CpG island methylator phenotype colorectal cancer. Gastroenterology 140:1174–1181CrossRefPubMedGoogle Scholar
  18. 18.
    Alm T (1975) Surgical treatment of hereditary adenomatosis of the colon and rectum in Sweden during the last 20 years. Part I. Introduction. Surgical procedures used. Pre-and postoperative measures. Arrangement of follow-up. Propositi group, primary and late results. Acta Chir Scand 141:218–227PubMedGoogle Scholar
  19. 19.
    Koskenvuo L, Mustonen H, Renkonen-Sinisalo L, Jarvinen HJ, Lepisto A (2014) Comparison of proctocolectomy and ileal pouch-anal anastomosis to colectomy and ileorectal anastomosis in familial adenomatous polyposis. Familial Cancer 14:221–227CrossRefGoogle Scholar
  20. 20.
    Castells A, Giardiello FM (2013) Familial colorectal cancer screening: so close, so far. Gastroenterology 144:492–494CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2018

Authors and Affiliations

  • Josep M. Borras
    • 1
  • Amanda C. R. K. Bos
    • 2
  • Antoni Castells
    • 3
  1. 1.Department of Clinical SciencesIDIBELL, University of BarcelonaBarcelonaSpain
  2. 2.Department of ResearchNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
  3. 3.Department of Gastroenterology, Hospital Clinic, IDIBAPS, CIBERehdUniversity of BarcelonaBarcelonaSpain

Personalised recommendations