Overview

Abstract (English)

Colorectal cancer is most common cancer diagnosed in both men and women in Canada and the second most common cause of cancer death. Variation in cancer burden across the country is greater than for any other major cancer, with the highest mortality rate nearly double the lowest; mortality rates, like incidence rates, are highest in the east and lowest in the west. Colorectal cancer is considered largely preventable, with several well-established modifiable risk factors and effective screening techniques available. “Convincing” evidence, including clear dose response effects, exists to support insufficient physical activity, greater body fatness (measured by body mass index (BMI)), alcohol consumption, and red meat and processed meat consumption as risk factors for colorectal cancer. Sufficient evidence also supports cigarette smoking as a risk factor for both colorectal cancer, and precursor adenomas. Hormone replacement therapy (HRT) has a protective effect, although the risks for conditions other than colorectal cancer may outweigh any benefit. 6 Colorectal cancer screening can facilitate prevention through the identification and removal of precancerous lesions. Furthermore, screening using the fecal occult blood test (FOBT) in particular has been shown to reduce colorectal cancer mortality. As part of the Canadian Partnership Against Cancer’s Cancer Surveillance and Epidemiology Network initiative, the Colorectal Cancer Network (CRCNet) aims to create comprehensive information products to inform and monitor control interventions for colorectal cancer. Through a collaboration of several provincial agencies, the CRCNet is conducting a comprehensive examination of colorectal cancer burden across multiple provinces and at the national level. Colorectal incidence rates and trends are complex and differ between sexes and across provinces. Explanations for the trends and inter-provincial variations in cancer burden are likely complex themselves and may include variation in risk factor prevalence and screening uptake. This report examines colorectal risk factors and screening behaviours among the Canadian provinces and territories. Subsequent reports will examine these factors and behaviours in relation to several socio-demographic characteristics, and will consider incidence variation in light of risk factors and screening behaviours. Key findings of this report: * About a fifth of Canadians defined themselves in 2009 as current smokers, as did onequarter of those aged 20-44, with more male than female smokers in every age group and almost every province/territory. * Alcohol consumption at the level linked with colorectal cancer risk varied little across Canada. Rates were higher in males (31% all ages), than in females (16%), and in both sexes were much higher in the 18-44 age range than for older adults. * Almost one-fifth of Canadian adults are obese, and a higher proportion – 40% of males and 27% of females – are overweight. * 53% or so of Canadian adults are, by self-report, at least moderately physically active in their leisure time and active transportation, with only 27% meeting the “active” definition. Levels for usual daily activities or work habits are higher, approaching 75%. * Almost half of adult Canadians spend more than 15 leisure hours per week in the sedentary pursuits of watching television or using a computer. * Red meat consumption exceeds the recommended cancer prevention level among 25% of Canadian men and 14% of women. * Hormone replacement therapy use is low levels among Canadian women, with a national average of 8.7% and with Québec significantly higher, at 13.5%. * Fecal occult blood testing for colorectal cancer detection was at low levels of around 23% in 2008, reflecting the lack of organized provincial colorectal screening programs prior to 2007. * Provinces and territories show varying patterns of risk modifiers and screening behaviours.

Abstract (French)

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