&NA;International trends show an increasing incidence of colorectal cancer in developed countries, although the mortality may be declining. There does not appear to be a left‐to‐right shift of colorectal cancers. The prevalence of hereditary colon cancer syndromes ranges from 1% to 5%, and breast cancer prevalence is also increased in family members. The risk of colon cancer in ulcerative colitis and Crohn's disease is better defined. The debate over the predictive value of distal hyperplastic polyps for proximal adenomas and cancers continues, but evidence suggests that distal hyperplastic polyps are not good predictors. Alcohol, tobacco, and animal fat intake appear to be epidemiologic risk factors.Current Opinion in Gastroenterology 1992,8:19‐24