Epidemiology and socioeconomic correlates of colorectal cancer in Asia in 2020 and its projection to 2040

Abstract

Asia bears a disproportionate and rapidly rising burden of colorectal cancer (CRC). However, the incidence and mortality trends vary significantly between Asian countries, mainly due to the diversity of socioeconomic factors and the implementation of screening programs. This study aimed to report the contemporary distribution, socioeconomic correlates, and projections for future trends of CRC across Asia. The Global Cancer Observatory (GLOBOCAN) for the year 2020 was used to obtain data on prevalence, incidence, and mortality rates of CRC. We calculated mortality-to-incidence ratios (MIRs), age-standardized incidence and mortality rates (ASIR and ASMR), crude rates, numbers, and 5-year prevalent cases and rates by age, sex, and subregions of Asia. We assessed the correlation between indicators and human development index (HDI) and the ratio of current health expenditure (CHE) to gross domestic product (GDP) using Pearson's correlation coefficient. Estimated incidence or mortality rates between 2025 and 2040 were calculated by multiplying age-specific rates for 2020 by the estimated population between 2025 and 2040. In Asia, the 5-year prevalence rate, ASIR, and ASMR of CRC were 55.60, 17.30, and 8.40 per 100,000, respectively. The highest crude incidence and mortality rates were in the 70 + age group. Males had higher ASIRs than females (20.80 vs. 14.00 per 100,000) in Asia. MIRs for men and women were 0.49 globally and 0.50 and 0.51 in Asia, respectively. A positive significant correlation was observed between HDI and both the ASIR and ASMR. A strong negative correlation was observed between HDI and MIR. The number of incident and mortality cases are estimated to increase by 71.10% and 85.10% in 2040, respectively. CRC is a significant public health concern in Asia, with substantially high incidence and mortality rates in East Asia and lower quality of care and survival in less developed regions of the continent. Resource allocation prioritizing population-based screenings alongside capacity building around specialized care centers is crucial across the Asian countries.

Keywords: Colon cancer; Colorectal neoplasm; Epidemiology; GLOBOCAN; Incidence; Mortality; Prevalence.

Fig. 1

Distribution of (A) five-year prevalence rate, (B) age-standardized incidence and (C) age-standardized mortality rates per 100,000 of colorectal cancer among both sexes in Asia in 2020.

Fig. 2

(A) Incident numbers and incidence rate, and (B) mortality numbers and mortality rate of colorectal cancer among males and females in each age group in Asia in 2020.

Fig. 3

(A) Five-year prevalence rate, (B) age-standardized incidence and (C) age-standardized mortality rates per 100,000 of colorectal cancer in Asia in 2020, by country and sex.

Fig. 3

(A) Five-year prevalence rate, (B) age-standardized incidence and (C) age-standardized mortality rates per 100,000 of colorectal cancer in Asia in 2020, by country and sex.

Fig. 3

(A) Five-year prevalence rate, (B) age-standardized incidence and (C) age-standardized mortality rates per 100,000 of colorectal cancer in Asia in 2020, by country and sex.

Fig. 4

Correlation of human development index (HDI) with (A) age-standardized incidence rate, (B) age-standardized mortality rate, and (C) mortality-to-incidence ratio. Correlation of the current healthcare expenditure to gross domestic product (CHE/GDP%) with (D) age-standardized incidence rate, (E) age-standardized mortality rate, and (F) mortality-to-incidence ratio of colorectal cancer in Asia in 2020.

Fig. 5

Estimated colorectal cancer (A) incidence and (B) mortality from 2020 to 2040 in Asia. The baseline scenario (represented by the black line), posits that there are no alterations in incidence and mortality, meaning that any rise in numbers is solely attributed to changes in population size and composition. Due to the unlikelihood of stable incidence rates, alternative scenarios are provided.