General Considerations

Diseases of the abdomen are common. In the United States, approximately 10% of the adult male population is affected by peptic ulcer disease. Five percent of the population older than 40 years has diverticular disease. Colorectal cancer is the third common malignant neoplasm (11% of all cancers) affecting American men and women. It is the second most common cause of cancer deaths in men (10%) and the third most common cause in women (11%). In 2007, approximately 158,410 new cases of cancer of the colon and rectum were diagnosed, and there were 52,870 deaths from colorectal cancer.

In the general American population, the lifetime probability for development of colorectal cancer is approximately 5.5%, or 1 per 18 people. The risk for this type of cancer differs widely among individuals. The highest incidence is in African Americans, who have a rate of 50.4 cases per 100,000 population. The incidence for the white population is second, at 43.9 per 100,000. The lowest incidence is in the Native American population, at 16.4 per 100,000. Some patients, such as those with congenital polyposis or ulcerative colitis, have a predisposition to the development of cancer of the colon, frequently at an early age. The lifetime risk of colonic cancer in patients with polyposis coli is 100%. The incidence of polyposis in the population of the United States varies from 1 per 7000 to 1 per 10,000 live births. The risk for development of colonic cancer in patients with ulcerative colitis is 20% per decade of life. Diet has been shown to have a relationship to the incidence of colonic cancer. Individuals on a low-fiber and high-fat diet are at higher risk. Earlier physical diagnosis has been clearly shown to lower the mortality rates for colorectal cancer

In 2007, in addition to deaths related to cancer of the colon and rectum, deaths from cancer of the liver and intrahepatic bile ducts accounted for 4% (12,540 patients) of all cancer deaths in men. There were also 37,170 new cases of pancreatic cancer and 33,370 deaths, which account for 6% of all cancer deaths in men and women in the United States. There were 15,560 new cases of esophageal cancer, with a 4:1 male-female ratio and 13,940 deaths, which makes esophageal cancer the seventh leading cause of cancer deaths in men (4% of all cancer deaths).

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