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Chapter 1 - Epidemiology, risk factors and pathogenesis

Epidemiology of gastrointestinal tract tumours

Overall, tumours of the gastrointestinal (GI) tract (International Classification of Diseases for Oncology [ICD-O] codes C15-C26) represent about one quarter of all cancers diagnosed in Europe.

In Europe, about 900 000 new cases of tumours of the GI tract were diagnosed in 2018, out of the more than 3.5 million new cases of cancer overall.

Half of GI tract tumours are colorectal cancers (CRCs), followed by cancers of the stomach and pancreas (14% each), and finally liver and oesophageal cancers.

GI cancers account for almost one third of all cancer deaths, or about 600 000 deaths out of more than 1.6 million cancer deaths (Europe, 2018).

This relatively high proportion of deaths compared with incidence in GI cancers is due to the fact that these tumours include some cancers with poor prognosis.

CRC deaths account for ~40% of all GI cancer deaths, followed by pancreatic and stomach cancers (21% and 17%, respectively).

Among GI tumours, only those from the colon and rectum have a relatively good prognosis. The 5-year survival is slightly over 60% (average for Europe).

Other tumours within this group show relatively poor prognosis, with 5-year survival below 20%, including pancreatic cancer, where 5-year survival is still below 10%.

CRC survival has increased by ~5% (patients diagnosed in 2010-2014 compared with 2000-2007), but improved only by 1%-1.5% for the remaining GI tumours in the
same period.

Revision Questions

  1. What proportion of all cancers diagnosed in Europe represents tumours of the GI tract?
  2. Across all tumour types, why is the mortality from GI tumours higher than the incidence?
  3. Which tumours of the GI tract have a poor prognosis, according to their survival rates?
Editors, Contributors and DOIs Oesophageal Cancer

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