Colorectal cancer (CRC) is among the most prevalent malignancies worldwide, representing the second leading cause of cancer-related mortality and accounting for approximately 2 million new cases and nearly half a million deaths annually. Global age-standardized incidence rates are highest in Australia/New Zealand and other Western countries, and lowest in parts of sub-Saharan Africa and South Asia, reflecting variations in demographics, lifestyle exposures, and screening practices. Colon cancer constitutes the larger fraction of CRC cases, with rectal cancer contributing substantially, and early-onset CRC (<50 years) is increasing across both high-income and emerging regions. Established risk factors include age, hereditary syndromes, obesity, sedentary behavior, dietary patterns, metabolic disorders, and chronic inflammation, with notable distinctions between colon and rectal subsites. This narrative review provides a comprehensive overview of CRC epidemiology, molecular and genetic pathogenesis, staging, and modern therapeutic approaches, addressing colon and rectal cancers separately due to their distinct biology, clinical behavior, and treatment strategies. By integrating current knowledge on genetic drivers, systemic and local therapies, and patient stratification, the review aims to inform clinical practice, support clinical trial design, discuss ongoing challenges and future perspectives, and foster further research toward precision-guided management of CRC.
结直肠癌是全球范围内最常见的恶性肿瘤之一，是癌症相关死亡的第二大原因，每年新发病例约200万例，死亡近50万例。全球年龄标准化发病率在澳大利亚/新西兰及其他西方国家最高，在撒哈拉以南非洲和南亚部分地区最低，这反映了人口结构、生活方式暴露及筛查实践的差异。结肠癌占结直肠癌病例的较大比例，直肠癌也占相当比重，且早发性结直肠癌（<50岁）在高收入地区及新兴地区均呈上升趋势。已确立的风险因素包括年龄、遗传综合征、肥胖、久坐行为、饮食模式、代谢紊乱及慢性炎症，其中结肠与直肠亚部位之间存在显著差异。本文通过叙述性综述全面概述了结直肠癌的流行病学、分子与遗传发病机制、分期及现代治疗方法，鉴于结肠癌与直肠癌在生物学特性、临床行为及治疗策略上的差异，本文对两者分别进行了探讨。通过整合当前关于遗传驱动因素、全身与局部治疗及患者分层的最新知识，本综述旨在为临床实践提供参考，支持临床试验设计，讨论当前面临的挑战与未来展望，并推动进一步研究以实现结直肠癌的精准化管理。
Genetic, Epidemiological, Clinical, and Therapeutic Trajectories in Colon and Rectal Cancers
肿瘤(癌症)患者之家