Colorectal cancer epidemiology (1990-2050): lessons from the Australasian experience

Abstract

Background: CRC is regarded as a worldwide health issue, exhibiting considerable geographic differences. The current research examines the global epidemiology of CRC (1990-2021) and forecasts trends until 2050, focusing specifically on Australasia.

Methods: We performed an extensive analysis using data from the Global Burden of Disease 2021 study to calculate age-standardized incidence and mortality rates (ASIR/ASMR) for CRC from 1990 to 2021. Analyses were divided by sex, age, geographic area, and SDI. Temporal trends were evaluated by utilizing EAPC. We assessed the impact linked to significant modifiable risk factors such as dietary risks, elevated body mass index, alcohol consumption, smoking, and lack of physical activity using comparative risk evaluation techniques. To forecast CRC mortality until 2050, we utilized a Bayesian Age-Period-Cohort (BAPC) model that includes demographic and temporal factors.

Results: Regions with high SDI exhibit the highest incidence of CRC but show decreasing trends, whereas regions with middle SDI are experiencing increasing burdens. Australasia, despite its historically high rates, accomplished notable reductions in mortality (-1.95% per year), positioning itself alongside Austria and Germany as frontrunners in CRC management. The rate of CRC occurrence is believed to be greater in males than in females. Dietary elements are the primary alterable risk factor worldwide, particularly in affluent areas. Forecasts and future estimates indicate additional declines in mortality rates in high-income areas, while transitioning economies face rising burdens.

Conclusion: The burden of CRC is moving towards developing areas. Australasia showcases effective cancer management via screening and treatment, offering essential insights for global policies and strategies addressing changeable risks.

Keywords: Australasia; Cancer epidemiology; Colorectal cancer; Global burden; Sociodemographic disparities.

Fig. 1

Global patterns of CRC burden by age and SDI, 1990–2021. (A) Age-specific incidence rates stratified by SDI levels and sex. (B) Age-specific cumulative incidence number stratified by SDI levels and sex. (C) Age-specific mortality rates stratified by SDI levels and sex. (D) Age-specific cumulative mortality number stratified by SDI levels and sex

Fig. 2

Regional disparities in colorectal cancer by SDI level over time, 1990–2021. (A) ASIR per 100,000 populations. (B) Absolute incidence numbers across all ages. (C) ASMR per 100,000 populations. (D) Absolute mortality numbers across all ages. Data presented for both sexes combined, females, and males separately across five SDI regions

Fig. 3

Regional patterns of colorectal cancer burden, 1990–2021. (A) ASIR by major world regions. (B) ASIR by specific geographic subregions. (C) Average ASIR across the study period by region. (D) ASMR by major world regions. (E) ASMR by specific geographic subregions. (F) Average ASMR across the study period by region

Fig. 4

EAPC in CRC burden, 1990–2021. (A) EAPC in ASIR by SDI region and sex. (B) EAPC in ASMR by SDI region and sex. (C) EAPC in ASIR by specific geographic region and sex. (D) EAPC in ASMR by specific geographic region and sex

Fig. 5

Geographic distribution of CRC trend patterns, 1990–2021. (A) World map of EAPC in ASIR for both sexes. (B) World map of EAPC in age-standardized mortality rates (ASMR) for both sexes

Fig. 6

Age-standardized mortality rates (ASMR) per 100,000 populations attributable to major risk factors for CRC by region, comparing 1990 and 2021. Bar charts display five key risk factors (dietary risks, high body mass index, alcohol use, smoking, and low physical activity) across 21 global regions

Fig. 7

Projected trends in CRC mortality from 2022 to 2050 by region. (A) Predicted age-standardized mortality rates (ASMR) per 100,000 for men across 21 global regions. (B) Predicted age-standardized mortality rates (ASMR) per 100,000 for women across 21 global regions. Blue shaded areas represent uncertainty intervals