Background and purpose: Colorectal cancer is one of the most common gastrointestinal cancers. There were about 1.36 million new cases of colorectal cancer

which was the third highest incidence of malignant tumors of the world in 2012. It was the fourth leading cause of cancer death and became a serious threat to human health. The aim of the study was to estimate the colorectal cancer burden in Hebei Province with the data of cancer registries areas and analyze the trend of colorectal cancer mortality rates with three of the Hebei Province death retrospective surveys. Methods: Nine cancer registries in Hebei Province submitted cancer registry data from 2010 to 2012 to the Hebei Provincial Cancer Registry Center. The pooled data were stratified by gender and age (0

1-4

5-9

10-14…80+). Proportions and incidence/mortality rates for colorectal cancer were calculated. Incidence and mortality rates were age-standardized to Chinese population census in 2000 and world Segi’s population standard. Colorectal cancer mortality data during the periods 1973-1975

1990-1992 and 2004-2005 were extracted from the death retrospective surveys and analyzed. Mortality and incidence rate data from Cixian County from 1988 to 2012 and Shexian County from 2000 to 2012 were obtained in each county and analyzed using Joinpoint regression model. Results: The estimated number of newly diagnosed colorectal cancer cases and deaths from 2010 to 2012 in cancer registry areas of Hebei Provinc were 2 303 and 1 229

respectively. The crude incidence rate of colorectal cancer was 16.48/100 000 (male 18.12/100 000 and female 14.77/100 000). The age-standardized incidence rate by Chinese population census (ASRC) in 2000 was 13.74/100 000. The colorectal cancer mortality rate was 8.79/100 000 (male 10.23/100 000 and female 7.31/100 000). The age-standardized mortality rate by Chinese population census (ASRC) in 2000 was 7.59/100 000. The mortality rates of colorectal cancer displayed a significant increasing trend in Hebei Province from 1973-1975 to 2010-2012

with an increased rate of 28.03%. In Cixian County

the annual percentage change (APC) of colorectal cancer incidence rate was 3.55

while the APC of colorectal cancer mortality rate was 1.64 for males from 1988 to 2012. In Shexian County

the APC of colorectal cancer incidence rates were 4.68 and 9.17 for males and females from 2000 to 2012

respectively; the APC of colorectal cancer mortality was 5.61 for males in Shexian County. Conclusion: The incidence and mortality rates of colorectal cancer showed an increasing trend in Hebei Province over the past 40 years. It is an important task that colorectal cancer screening is strengthened to reduce morbidity and mortality of the colorectal cancer in Hebei Province.