(within the muscular layer) have an average five-year survival rate of approximately 90%. those with a more invasive tumor yet without node involvement (t3-4, n0, m0) have an average five-year survival rate of approximately 70%. people with positive regional lymph nodes (any t, n1-3, m0) have an average five-year survival rate of approximately 40%, while those with distant metastases (any t, any n, m1) have a poor prognosis and the five year survival ranges from <5 percent to 31 percent. the prognosis depends on a multitude of factors which include the physical fitness level of the person, extent of metastases, and tumor grade. whilst the impact of colorectal cancer on those who survive varies greatly there will often be a need to adapt to both physical and psychological outcomes of the illness and its treatment. for example, it is common for people to experience incontinence, sexual dysfunction, problems with stoma care and fear of cancer recurrence after primary treatment has concluded. a qualitative systematic review published in 2021 highlighted that there are three main factors influencing adaptation to living with and beyond colorectal cancer: support mechanisms, severity of late effects of treatment and psychosocial adjustment. therefore, it is essential that people are offered appropriate support to help them better adapt to life following treatment. epidemiology colon and rectum cancer deaths per million persons in 2012 3–17 18–21 22–27 28–36 37–54 55–77 78–162 163–244 245–329 330–533 globally more than 1 million people get colorectal cancer every year resulting in about 715,000 deaths as of 2010 up from 490,000 in 1990. as of 2012, it is the second most common cause of cancer in women (9.2% of diagnoses) and the third most common in men (10.0%): 16 with it being the fourth most common cause of cancer death after lung, stomach, and liver cancer. it is more common in developed than developing countries. global incidence varies 10-fold, with highest rates in australia, new zealand, europe and the us and lowest rates in africa and south-central asia. united states in 2022, the incidence of colorectal cancer in the united states was anticipated to be about 151,000 adults, including over 106,000 new cases of colon cancer (some 54,000 men and 52,000 women) and about 45,000 new cases of rectal cancer. since the 1980s, the incidence of colorectal cancer decreased, dropping by about 2% annually from 2014 to 2018 in adults aged 50 and older, due mainly to improved screening. however, incidence of colorectal cancer has increased in individuals aged 25 to 50. in early 2023, the american cancer society (acs) reported that 20% of diagnoses (of colon cancer) in 2019 were in patients under age 55, which is about double the rate in 1995, and rates of advanced disease increased by about 3% annually in people younger than 50. it predicted that, in 2023, an estimated 19,550 diagnoses and 3,750 deaths would be in people younger than 50. colorectal cancer also disproportionately affects the black community, where the rates are the highest of any racial/ethnic group in the us. african americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups. black americans often experience greater obstacles to cancer prevention, detection, treatment, and survival, including systemic racial disparities that are complex and go beyond the obvious connection to cancer. united kingdom in the uk about 41,000 people a year get colon cancer making it the fourth most common type. australia one in 19 men and one in 28 women in australia will develop colorectal cancer before the age of 75; one in 10 men and one in 15 women will develop it by 85 years of age. papua new guinea in the developing countries like papua new guinea and other pacific island states including the solomon islands, colorectal cancer is a very rare cancer amongst the people, which is least common compared to lung, stomach, liver or breast cancer. it is estimated that at least 8 in 100,000 of the people are most likely to developed colorectal cancer every year, which is unlike lung or breast cancer, where for the latter alone is 24 in 100,000 of the women folks alone. history rectal cancer has been diagnosed in an ancient egyptian mummy who had lived in the dakhleh oasis during the ptolemaic period. society and culture in the united states, march is colorectal cancer awareness month. research preliminary in-vitro evidence suggests lactic acid bacteria (e.g., lactobacilli, streptococci or lactococci) may be protective against the development and progression of colorectal cancer through several mechanisms such as antioxidant activity, immunomodulation, promoting programmed cell death, antiproliferative effects, and epigenetic modification of cancer cells. mouse models of colorectal and intestinal cancer have been developed and are used in research. the cancer genome atlas the colorectal cancer atlas integrating genomic and proteomic data pertaining to colorectal cancer tissues and cell lines have been developed.