91 INVITED Optimal strategy for integration of biologics in treatment of metastatic colorectal cancers

Colorectal cancer (CRC) is the third most common malignancy in the ‘developed’ world, after lung and breast cancer, and causes about 16,000 deaths per year in the UK and 500,000 deaths world-wide annually. It usually occurs in the 7th or 8th decade and has a similar incidence in men and women. The overall five-year survival rate from large bowel cancer is approximately 50%. Despite improvements in diagnosis, surgical technique, perioperative care and postoperative therapies, the incidence and mortality from this disease has changed little over the past 40 years.This article concentrates on recent innovations and topical areas in large bowel cancer with particular emphasis on CRC risk and prevention. It also provides an update on changes in the management of CRC. Previous articles in this series have covered presentation, surgery and pathology (Surgery 2000; 18(2): i–iv and 40–4). The reader is also referred to the section on intestinal obstruction, as up to 30% of large bowel cancers present as emergencies with obstruction or perforation (Surgery 2000; 18(2): 33–9).