OBJECTIVES : This study aimed to update colorectal cancer incidence and mortality trends in Spain and provide a detailed analysis of disease management and risk factors involved in in-hospital mortality.

METHODS : Anonymised primary and specialised care admission records from 2011 to 2016 were extracted from a Spanish claims database representative of all Spanish regions. The standardised average expenses of medical procedures determined by the Spanish Ministry of Health were utilised for the calculation of direct medical costs.

RESULTS : Primary care files from 37,317 patients and specialised care files from 192,048 patients were obtained. In-hospital mortality rate was 10.07% and remained stable during the study period, similarly to colorectal cancer incidence within the hospitalised population, which was 106 per 10,000 patients. Patients deceased during the hospitalisation presented an increased presence of metastatic tumours. Mean length of hospital stay decreased significantly over the study period, similarly to patients’ 30-day readmission rate, which registered a decrease from the 15.29% to 13.58% (p<0.001). In consequence, the direct medical cost measured per patient, of €10,992, decreased over time. The implementation of colorectal cancer screening programmes caused a significant decrease in the number of new diagnoses in patients aged 75 to 79 years; however, in-hospital mortality was not reduced. Metastatic tumours and other conditions as anaemia are associated with higher in-hospital mortality rates.

CONCLUSIONS : The implementation of colorectal cancer screening programmes in Spain presumably provoked the decrease in the number of new diagnoses in patients aged 75 to 79 years; however, in-hospital mortality remained stable. Such programmes should be promoted to achieve higher participation rates in an effort to reduce incidence and the number of patients presenting metastasis at first admission. The roles of anaemia and overweight in colorectal cancer mortality should be further investigated to determine their value in improving patients’ prognosis.