Analysis of trends in the burden of colorectal cancer in China and globally from 1990 to 2021 with projections for the next 15 years: a cross-sectional study based on the GBD database

Abstract

Objective: To analyze the changes in the burden of colorectal cancer in China and globally from 1990 to 2021, and to explore the disease burden across different age groups and sexes by integrating projected data from 2022 to 2036. This study aims to provide a scientific foundation for formulating targeted prevention and control strategies.

Materials and methods: This study utilized colorectal cancer data from the Global Burden of Disease (GBD) database for the period 1990-2021. Trend analysis was conducted using Joinpoint regression, and future burden projections from 2022 to 2036 were made with an Auto-Regressive Integrated Moving Average (ARIMA) model. Key indicators analyzed included the Age-Standardized Incidence Rate (ASIR), Age-Standardized Prevalence Rate (ASPR), Age-Standardized Mortality Rate (ASMR), and Disability-Adjusted Life Years (DALYs).

Results: Between 1990 and 2021, the burden of colorectal cancer increased both in China and globally, although notable differences were observed across gender and regions. In Chinese men, the ASIR and ASMR have shown a continuous rise, reaching approximately 50 and 300 per 100,000, respectively, by 2021. Projections indicate that these rates will continue to increase through at least 2036. The ASIR in Chinese women also exhibits an upward trend, whereas the global ASIR for women has declined. From 1990 to 2021, both China and the world experienced a steady rise in ASPR, with minimal fluctuations. In contrast, while the ASDR has decreased in both China and globally, the volatility in China's ASDR is notably more pronounced than that observed worldwide.

Conclusion: The burden of colorectal cancer in China is projected to increase significantly in the coming years, particularly among males and the older adult population. This study provides critical scientific insights for the development of targeted prevention strategies and resource allocation, underscoring the urgent need to enhance early screening initiatives and health education efforts in China.

Keywords: colorectal cancer; disease burden; incidence rate; prevalence rate; prevention.

Figure 1

Age-Standardized Incidence Rate (ASIR), Age-Standardized Prevalence Rate (ASPR), Age-Standardized Mortality Rate (ASMR), and Disability-Adjusted Life Year Rate (ASDR) APCs for colorectal cancer in China, 1990–2021 (* indicates p < 0.05, denoting statistical significance). (A) ASIR; (B) ASPR; (C) ASMR; (D) ASDR.

Figure 2

Age-Standardized Incidence Rate (ASIR), Age-Standardized Prevalence Rate (ASPR), Age-Standardized Mortality Rate (ASMR), and Disability-Adjusted Life Year Rate (ASDR) APCs for global colorectal cancer, 1990–2021 (* indicates p < 0.05, denoting statistical significance). (A) ASIR; (B) ASPR; (C) ASMR; (D) ASDR.

Figure 3

Comparison of age-specific incidence, prevalence, mortality, and DALYs counts and crude rates for colorectal cancer in China by age group in 1990 and 202. (A) Incidence and incidence rate. (B) Prevalence and prevalence rate. (C) Mortality and mortality rate. (D) Disability-Adjusted Life Years (DALY) and DALY rate.

Figure 4

Comparison of age-specific incidence, prevalence, mortality, and DALYs counts and crude rates for colorectal cancer globally by age group in 1990 and 2021. (A) Incidence and incidence rate. (B) Prevalence and prevalence rate. (C) Mortality and mortality rate. (D) Disability-Adjusted Life Years (DALY) and DALY rate.

Figure 5

Comparison of age- and sex-specific incidence and prevalence counts for colorectal cancer in China in 1990 and 2021. (A) represents the number of colorectal cancer cases in China in 1990. (B) represents the number of prevalent colorectal cancer cases in China in 1990. (C) represents the number of colorectal cancer cases in China in 2021. (D) represents the number of prevalent colorectal cancer cases in China in 2021.

Figure 6

Comparison of age- and sex-specific incidence and prevalence counts for colorectal cancer globally in 1990 and 2021. (A) represents the number of colorectal cancer cases worldwide in 1990. (B) represents the number of prevalent colorectal cancer cases worldwide in 1990. (C) represents the number of colorectal cancer cases worldwide in 2021. (D) represents the number of prevalent colorectal cancer cases worldwide in 2021.

Figure 7

Projected trends in colorectal cancer incidence and mortality rates in China over the next 15 years (2022–2036). The red line represents the actual trend in colorectal cancer incidence and mortality rates in China from 1990 to 2021, while the yellow dashed line and shaded area denote the projected trend and its 95% confidence interval for 2022–2036. (A) represents the age-standardized incidence rate (ASIR) and its projection for colorectal cancer in Chinese males. (B) represents the age-standardized incidence rate (ASIR) and its projection for colorectal cancer in Chinese females. (C) represents the age-standardized mortality rate (ASMR) and its projection for colorectal cancer in Chinese males. (D) represents the age-standardized mortality rate (ASMR) and its projection for colorectal cancer in Chinese females.

Figure 8

Projected trends in global colorectal cancer incidence and mortality rates over the next 15 years (2022–2036). The red line represents the actual trend in global colorectal cancer incidence and mortality rates from 1990 to 2021, while the yellow dashed line and shaded area indicate the projected trend and its 95% confidence interval for 2022–2036. (A) represents the age-standardized incidence rate (ASIR) and its projection for colorectal cancer in males worldwide. (B) represents the age-standardized incidence rate (ASIR) and its projection for colorectal cancer in females worldwide. (C) represents the age-standardized mortality rate (ASMR) and its projection for colorectal cancer in males worldwide. (D) represents the age-standardized mortality rate (ASMR) and its projection for colorectal cancer in females worldwide.