The incidence and survival rates of colorectal cancer in India remain low compared with rising rates in East Asia.

Background: During the past 3 decades, the incidence of colorectal cancer was at a low level in urban and rural populations in India, in comparison with figures observed in developed countries of North America and Europe.

Objective: The aim of this study was to describe the time trends of incidence and mortality, and the survival rates of colorectal cancer, as well, in India.

Design: This is an ecological study.

Main Outcome Measures: The primary outcome measured is the incidence data extracted from selected Indian cancer registries in the volumes on cancer incidence in 5 continents.

Results: Low and stable incidence and mortality rates from colon and rectum cancers were observed in India in both men and women. However, this low incidence rate was associated with a low 5-year relative survival rate.

Conclusions: It is likely that the prevailing environmental factors and lifestyle, including a reduced consumption of sugars, calories and fat-rich food, an increased consumption of vegetables and fruits, and an adequate physical activity with avoidance of overweight and obesity, are responsible for the low risk of colorectal cancers. In contrast, the low survival, even for localized cases, suggests severe deficiencies in early diagnosis and effective treatment in India. A strategy to control the disease in India, based on improving awareness of the risk factors for colorectal cancer while keeping the traditional lifestyle, and on investments in early diagnosis and adequate treatment should be implemented. However, an organized, population-based screening of colorectal cancer may not prove cost-effective, given the low burden of colorectal cancer.