Guidance on Cancer Services – Improving Outcomes in Colorectal Cancers – Manual Update [...]...Note on the update format This edition of Improving Outcomes in Colorectal Cancers is an updated version of the manual published by the Department of Health in 1997 This manual update covers cancers of the colon and rectum (bowel) as before, plus an additional section on anal cancer The Background section is intended as a general introduction to colorectal cancer, for people who are not experts in the... supplementation (29 cancer deaths in the 34 35 36 37 38 20 Bingham SA, Day NE, Luben R, Ferrari P, et al Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study Lancet 2003;361:1496-1501 Mai V, Flood A, Peters U, Lacey JV, et al Dietary fibre and risk of colorectal cancer in the Breast Cancer Detection Demonstration... and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial Lancet 2000;356:13001306 Dyer O Aspirin could be used to prevent cancer (News) BMJ 2003;326:565 Information from the US National Cancer Institute website Boyle P, Leon ME Epidemiology of colorectal cancer Brit Med Bull 2002;64:1-25... International Agency for Research on Cancer, 1999 Gatta G, Capocaccia R, Sant M, Bell CMJ, et al Understanding variations in survival for colorectal cancer in Europe: a EUROCARE high resolution study Gut 2000;47:533-538 This suggestion is based on the following strands of indirect evidence: • Fewer colonoscopies are carried out in relation to population in the UK than in the US and northern Europe Since... cigarette smoking increases risk of colorectal cancer Cancer Epidemiology, Biomarkers and Prevention 2001;10:725-731 Longnecker MP, Orza MJ, Adams ME, Vioque J, et al A meta-analysis of alcoholic beverage consumption in relation to risk of colorectal cancer Cancer Causes Control 1990;1:59-68 World Cancer Research Fund Food, nutrition and the prevention of cancer: a global perspective Washington, DC: WCRF,... in this section as they apply to cancer care generally It deals with the following topic areas: 1 1 2 User involvement in planning, delivering and evaluating services 3 Face-to-face communication 4 Information 5 Psychological support services 6 Social support services 7 Spiritual support services 8 General palliative care services, incorporating care of dying patients 9 Specialist palliative care services. .. England 64.9 (64.3 – 65.6) 64.2 (63.6 – 64.8) 70.5 (69.8 – 71.2) 71.8 (71.1 – 72.6) Scotland 65.7 (64.1 – 67.2) 65.7 (64.4 – 67.1) 71.3 (69.3 – 72.3) 71.3 (69.3 – 73.4) Wales 53.5 (51.5 – 55.7) 52.5 (50.6 – 54.5) 64.5 (62.3 – 66.9) 63.9 (61.3 – 66.6) Europe 69.2 (68.4 – 69.9) 69.8 (69.2 – 70.5) 73.7 (72.8 – 74.5) 75.2 (74.4 – 76.1) Table 2b One year relative survival for colorectal cancer in Wales, 1989-1993... Cancer trends in England and Wales 19501999 London: The Stationery Office, 2001 Source: data on Office for National Statistics website Source: Welsh Cancer Intelligence & Surveillance Unit, data provided on request, November 2002 The incidence of colorectal cancer is gradually increasing One reason for this is the ageing of the population: as with most forms of cancer, the probability... of colorectal cancer. 28,29 • Not smoking Long-term heavy smokers have two to three times the risk of developing colorectal adenoma, but it may be three or four decades before clinical colorectal cancer becomes apparent It has been estimated that up to 20% of colorectal cancers in the US could be due to smoking.30 The weak association that has been observed between alcohol consumption and colorectal cancer. .. evidence Information from sources which are not included in either review of research evidence is referenced in this document 1 Improving Outcomes in Colorectal Cancer: the Research Evidence (1997) Available from the Department of Health publication order line on 08701 555 455, reference No 23573 5 Key recommendations • Action should be taken to improve recognition of potential symptoms of colorectal cancer . Guidance on Cancer Services – Improving Outcomes in Colorectal Cancers – Manual Update