A disease of growth

Colorectal cancer occurs throughout the world but is most common in developed countries. As heavily populated countries such as China undergo rapid economic development, the incidence of the disease looks set to increase. An animated version of this infographic is at go.nature.com/wgiqvp. By David Holmes.

DISEASE AND DEVELOPMENT

More than half (55%) of the cases of colorectal cancer occur in developed regions, but developing countries are catching up. As the economies of countries such as Brazil, China and India grow, so does their incidence of colorectal cancer¹.

HEALTH OF NATIONS

Global trends in colorectal cancer closely follow economic fortunes². Incidence in Western Europe has been relatively flat for two decades, coinciding with a period of economic stability or decline. Meanwhile, Eastern European countries such as Slovakia have experienced rapid economic growth from a lower base, and have seen a corresponding rise in colorectal cancer.

Looking further east, Japan experienced a rapid rise in cases between 1990 and 1995, followed by almost ten years of steady or falling incidence. This period, termed ‘the lost decade’ by economists, saw falling wages and economic stagnation. By contrast, the breakneck development of Japan’s neighbour China was accompanied by a dramatic rise in colorectal cancer incidence.

SURVIVAL: NOT BLACK AND WHITE

The decline in colorectal cancer mortality in the United States has not been shared equally¹¹. In the 1980s, African Americans died at a 13% higher rate than white Americans from the disease. Two decades later, they died at a 53% higher rate¹². This disparity is caused by factors including differences in how likely they are to receive the latest treatments, and the prevalence of other health problems.

HOW IT SPREADS

Colorectal cancer affects the colon and the rectum, parts of the digestive system known as the large intestine. It usually begins as a non-cancerous growth called a polyp on the inner lining of the intestine.