2026-03-02
Colorectal cancer on the rise
Oncology
By Ana Espino | Published on March 2nd, 2026 | 3 min read
Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide and the second leading cause of cancer-related mortality. In 2022, more than 1.9 million new cases and 881,984 deaths were recorded globally.
Traditionally viewed as a cancer of Western countries, CRC is showing contrasting trends. High-income countries are seeing stabilization—or even a decline—in overall incidence thanks to screening.
In contrast, several middle-income countries, including India, are reporting a gradual increase in cases.
In India, CRC is the fourth most common cancer, with 64,863 new cases and 38,367 deaths in 2022. Although incidence remains lower than in Western countries, the proportionally high mortality and limited 5-year survival (≈34–38%) reflect late diagnosis and inequities in access to care.
This narrative review published in the Indian Journal of Gastroenterology examines CRC epidemiology with a specific focus on India, detailing trends, risk factors, and prevention perspectives.
This review draws on GLOBOCAN 2022 data, Indian cancer registries, and more than 50 international studies including cohorts, case–control studies, and meta-analyses. The analysis covers incidence, mortality, survival, and both modifiable and non-modifiable risk factors.
In India, the age-adjusted incidence rate (AAR) is 5.7 per 100,000 in men and 3.4 per 100,000 in women. Regional disparities are marked, with incidence up to two to five times higher in urban areas compared with rural areas.
Unlike Western countries, India has seen an annual increase of 2–3% over the past two decades. Projections suggest a doubling of incidence and mortality by 2050. Dietary factors play a central role. Consumption of red and processed meats, fried foods, and sugar-sweetened beverages significantly increases risk. Conversely, a diet rich in fiber, fruits, vegetables, dairy products, fish, legumes, and whole grains is protective.
Behavioral factors include smoking, alcohol, physical inactivity, and obesity, all strongly associated with tumor risk. Comorbidities such as diabetes, metabolic syndrome, and chronic inflammatory bowel diseases also increase risk. Genetic and familial factors—including Lynch syndrome, familial colorectal polyps, and BRCA mutations—contribute to individual risk.
Finally, certain medications such as metformin and aspirin show a protective effect, whereas exposure to pesticides, radiation, and industrial environments is associated with increased risk.
Colorectal cancer in India illustrates an epidemiological transition linked to urbanization and dietary change. Despite still-moderate incidence, the steady rise and high mortality are a warning signal.
This review aimed to synthesize epidemiological data and identify priority prevention levers. The findings confirm that nearly three-quarters of the CRC burden is attributable to modifiable factors.
However, Indian data rely largely on hospital-based and case–control studies, which are prone to methodological bias. The absence of national screening programs also limits early detection.
In a resource-limited context, systematic mass screening is not currently recommended. A pragmatic strategy relies on targeted screening of high-risk populations, health education, and modification of dietary and metabolic behaviors.
In the longer term, integrating nutrition policies, combating obesity, and improving access to diagnosis could slow the expected rise in CRC in India and sustainably reduce its public health impact.
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide and the second leading cause of cancer-related mortality. In 2022, more than 1.9 million new cases and 881,984 deaths were recorded globally.
Traditionally viewed as a cancer of Western countries, CRC is showing contrasting trends. High-income countries are seeing stabilization—or even a decline—in overall incidence thanks to screening.
In contrast, several middle-income countries, including India, are reporting a gradual increase in cases.
In India, CRC is the fourth most common cancer, with 64,863 new cases and 38,367 deaths in 2022. Although incidence remains lower than in Western countries, the proportionally high mortality and limited 5-year survival (≈34–38%) reflect late diagnosis and inequities in access to care.
This narrative review published in the Indian Journal of Gastroenterology examines CRC epidemiology with a specific focus on India, detailing trends, risk factors, and prevention perspectives.
Urbanization and diet: the real culprits?
This review draws on GLOBOCAN 2022 data, Indian cancer registries, and more than 50 international studies including cohorts, case–control studies, and meta-analyses. The analysis covers incidence, mortality, survival, and both modifiable and non-modifiable risk factors.
In India, the age-adjusted incidence rate (AAR) is 5.7 per 100,000 in men and 3.4 per 100,000 in women. Regional disparities are marked, with incidence up to two to five times higher in urban areas compared with rural areas.
Unlike Western countries, India has seen an annual increase of 2–3% over the past two decades. Projections suggest a doubling of incidence and mortality by 2050. Dietary factors play a central role. Consumption of red and processed meats, fried foods, and sugar-sweetened beverages significantly increases risk. Conversely, a diet rich in fiber, fruits, vegetables, dairy products, fish, legumes, and whole grains is protective.
Behavioral factors include smoking, alcohol, physical inactivity, and obesity, all strongly associated with tumor risk. Comorbidities such as diabetes, metabolic syndrome, and chronic inflammatory bowel diseases also increase risk. Genetic and familial factors—including Lynch syndrome, familial colorectal polyps, and BRCA mutations—contribute to individual risk.
Finally, certain medications such as metformin and aspirin show a protective effect, whereas exposure to pesticides, radiation, and industrial environments is associated with increased risk.
Act now to prevent a doubling
Colorectal cancer in India illustrates an epidemiological transition linked to urbanization and dietary change. Despite still-moderate incidence, the steady rise and high mortality are a warning signal.
This review aimed to synthesize epidemiological data and identify priority prevention levers. The findings confirm that nearly three-quarters of the CRC burden is attributable to modifiable factors.
However, Indian data rely largely on hospital-based and case–control studies, which are prone to methodological bias. The absence of national screening programs also limits early detection.
In a resource-limited context, systematic mass screening is not currently recommended. A pragmatic strategy relies on targeted screening of high-risk populations, health education, and modification of dietary and metabolic behaviors.
In the longer term, integrating nutrition policies, combating obesity, and improving access to diagnosis could slow the expected rise in CRC in India and sustainably reduce its public health impact.
Read next: Cancer: when biotin becomes a therapeutic lever
About the author – Ana Espino
PhD in Immunology, specialized in Virology
As a scientific writer, Ana is passionate about bridging the gap between research and real-world impact. With expertise in immunology, virology, oncology, and clinical studies, she makes complex science clear and accessible. Her mission: to accelerate knowledge sharing and empower evidence-based decisions through impactful communication.
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