Temporal Trends in the Disease Burden of Colorectal Cancer with Its Risk Factors at the Global and National Level from 1990 to 2019, and Projections Until 2044

Abstract

Background

This study aimed to evaluate the global colorectal cancer(CRC) trend and the relevant risk factors from 1990 to 2019 and for better policymaking and resource allocation.

Methods

Data on CRC, including incidence, mortality and disability adjusted life year (DALY) rates, were extracted from the 2019 Global Burden of Disease (GBD) study. The estimated annual percentage changes (EAPCs) were calculated to assess the temporal trend of incidence, mortality and DALYs. The Bayesian age-period-cohort model(BAPC) was used to predict the future burden of CRC.

Results

In 2019, a total of 2.17 million CRC cases were reported worldwide, a 157% increase from 1990. In high-social demographic index (SDI) regions, the trend of age-standardized incidence rate(ASIR) tended to decrease, while the proportion of people under 50 years of age tended to increase. Although the number of deaths and DALYs increased, the age-standardized death rate (ASDR) and age-standardized DALY rate decreased. The CRC burden was growing fastest in middle-SDI regions, especially in East Asia, followed by low SDI regions. In addition, the milk intake, High-BMI and high fasting plasma glucose play a more important role in on CRC. The predicted cases and deaths in global continued to increase to 2044. And there is an upward trend in ASIR for both men and women.

Conclusion

In developed regions, the CRC burden continues to decrease, while the CRC burden become more and more severe in developing regions. Overall, the burden of CRC will rising in the near future. Therefore, reasonable resource allocation and prevention policies should be implemented. Developing countries needs more attention.

Keywords:

• global burden of disease
• colorectal cancer
• disability-adjusted life year
• estimated annual percentage change
• age-standardized incidence rate
• Bayesian age-period-cohort

Abbreviations

ASDR, Age-standardized death rate; ASIR, Age-standardized incidence rate; ASR, Age-standardized rate; DALY, Disability-adjusted life year; EAPC, Estimated annual percentage change; GBD, Global burden of disease; SDI, Social-demographic index; UI, Uncertainty interval; BMI, Body−mass index; CI, confidence interval; BAPC, Bayesian age-period-cohort.

Data Sharing Statement

The datasets for this article are available from the Global Health Data Exchange query tool (http://ghdx.healthdata.org/gbd-results-tool).

Ethics Approval and Consent to Participate

This study was approved by The Fourth Affiliated Hospital, College of Medicine, Zhejiang University. The data obtained from the Global Health Data Exchange Query Tool did not require informed patient consent.

Acknowledgments

We would like to thank the Global Burden of Disease for providing open access to the database.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

This work was supported by grants from the National Natural Science Foundation of China, No. 81570698 (Dr. Bo Zhang) and the key project of Natural Science Foundation of Zhejiang Province (LZ20H160002), key research and development project of Zhejiang province (2021C03048).