The potential for prevention of colorectal cancer in the UK

On the basis of recent trends (up to 2004), future projections of the incidence of colorectal cancer in the UK in the next 24 years are for a continuing decline in rates (age-standardized rates predicted to be about 9% lower). The potential for modification of the predicted burden through the implementation of five preventive interventions, for which national policies or targets have been promulgated, is examined. We estimate that 31.5% of cancers in men and 18.4% in women could be prevented if reasonable targets with respect to diet (reduced consumption of red meat, increased fruit and vegetables), exercise (30 min 5 days a week), alcohol consumption (3 U a day for men, 2 U for women) and weight control were achieved. This estimate assumes a return of the weight profile of the UK population to that present 20 years ago; if the aim were simply to halt the increasing trend in overweight, the preventable fractions would be 28% in men and 14.7% in women. These predictions suggest that realistic lifestyle modifications can result in a substantial reduction in cases of this major cancer. The benefit in terms of avoided deaths is probably greater than that which can be achieved through implementation of the national screening programme, and improvements in treatment.