Research Square · Nov 12, 2026
An alarming rise in colorectal cancer incidence in Sri Lanka from 2010-2022; analysis of the national cancer registery from a South Asian cohort
By Nanayakkara P, Nanayakkara S, Madhuwanthi T et al.
Objective - This study aims to analyze the national trends in colorectal cancer (CRC) incidence in Sri Lanka over the past 13 years and identify the high-risk population groups for interventions. Mann-Kendall Trend test and Annual Percentage Change (APC) of Joinpoint Regression were used for the assess the trends. Results - Among 29,015 CRC cases (50.5% females), the percentage of CRC among all cancers increased from 6.38% (2010) to 8.59% (2022), maximum at 8.70% (2020). A significant increasing trend in CRC incidence was observed (τ = 0.82, p < 0.05), with an average annual percent change (AAPC) of 8.55% and a mean age-standardized incidence rate (ASR) of 9.23 per 100,000 populations (95% CI: 7.77–10.70). Females showed a sharper rise (AAPC = 8.97, p < 0.05), particularly during 2010–2016 (APC = 17.33, p < 0.05). Age-specific incidence rate (ASIR) increased significantly in those ≥40 years (40–59: τ = 0.72, APC = 10.33; ≥60: τ = 0.79, APC = 5.71; p < 0.05). A moderate increase was seen in the 20–39 age group (APC = 5.37, p < 0.05), with male shows the highest trend as APC = 12.05; p< 0.05. Conclusion - The incidence of CRC has rapidly risen in Sri Lanka, in all age groups above 40 years and in both sexes over the past 13 years. The APC is highest for the 40–59 year age group. These findings emphasize the need for age-stratified screening programs and targeted interventions beginning at age 40 for at-risk populations.