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. 2023 Jan 12:15:55-71.
doi: 10.2147/CLEP.S388323. eCollection 2023.

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

Yang Liu  1 , Chao Zhang  2 , Qianwen Wang  1 , Kangze Wu  3 , Zhouyi Sun  1 , Zhe Tang  1 , Bo Zhang  3
Affiliations

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

Yang Liu et al. Clin Epidemiol. .

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

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Conflict of interest statement

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

Figures

Figure 1
Figure 1
The distribution and trends of colorectal cancer incidence globally. (A) Global number of incident cases and incidence rate of colorectal cancer per 100000 person-years by age and sex, 2019 (B) The ASIR in global, SDI regions, and 21 GBD regions by sex (C) The percentage change in ASIR of colorectal cancer for global and SDI regions by age from 1990 to 2019 (D) The EAPC of colorectal cancer ASIR in global, SDI regions, and 21 GBD regions by sex.
Figure 2
Figure 2
The trend in ASIR (A) and ASDR (B) of colorectal cancer across 21 GBD regions and global by SDI for both sexes combined, 1990–2019. For each region, points from left to right depict estimates from each year from 1990 to 2019.
Figure 3
Figure 3
The global disease burden of colorectal cancer for both genders in 204 countries and territories. (A) The EAPC of Colorectal cancer ASIR from 1990 to 2019 (B) The EAPC of Colorectal cancer ASDR from 1990 to 2019 (C) The EAPC of Colorectal cancer age-standardized DALY rate from 1990 to 2019.
Figure 4
Figure 4
The distribution and trends of colorectal cancer death globally. (A) Global number of deaths and death rate of colorectal cancer per 100000 person-years by age and sex, 2019 (B) The ASDR in global, SDI regions, and 21 GBD regions by sex (C) The percentage change in ASDR of colorectal cancer for global and SDI regions by age from 1990 to 2019 (D) The EAPC of colorectal cancer ASDR in global, SDI regions, and 21 GBD regions by sex.
Figure 5
Figure 5
The observed (dashed line) and predicted (solid line) cases (A) and deaths (B) of colorectal cancer from 1990 to 2044. The upper bound of Shading represents the rate increased by 1% per year (pessimistic reference) and the lower bound represents decreased by 1% per year (optimistic reference) based on the rate observed in 2019.
Figure 6
Figure 6
Percentage of attributable to risk factors of colorectal cancer in different year or gender. (A) deaths attributable to risk factors between 1990 and 2019 (B) deaths attributable to risk factors between 1990 and 2019 (C) deaths attributable to risk factors between different gender in 2019 (D) deaths attributable to risk factors between different gender in 2019.
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