Global, regional, and national burden of colorectal cancer in the elderly (aged > 60 years): a comprehensive analysis across 204 countries and territories (1990-2021)​

Abstract

Background: Colorectal Cancer (CRC) is highly prevalent among the elderly (Aged > 60 Years). Investigating the global epidemiological trends of colorectal cancer in elderly patients can aid in developing targeted prevention and control measures.

Methods: The epidemiological data on CRC in the elderly were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, encompassing annual estimates from 1990 to 2021. The acquired metrics included incidence, prevalence, deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). We analyzed temporal trends of these diverse disease burden indicators for CRC in the elderly population. Furthermore, the Bayesian age-period-cohort (BAPC) model was employed to project future the elderly CRC burden at both national and regional levels.

Results: In 2021, the global elderly CRC had a total incidence of 1,617,011 (1,447,212-1,754,348), with an age-standardized incidence rate (ASIR) of 149.16 (133.11-161.91). The total prevalence was 8,079,970 (7,332,761-8,727,386), with an age-standardized prevalence rate (ASPR) of 737.47 (668.26-796.77). Total deaths numbered 827,471 (736,233-897,443), with an age-standardized death rate (ASDR) of 77.51 (68.71-84.13). Total DALYs were 15,347,705 (13,913,323- 16,592,781), with an age-standardized DALYs rate of 1407.18 (1272.56-1522.03). Total YLDs were 764,739 (562,029-991,490), with an age-standardized YLDs rate of 70.16 (51.55-90.93). Total YLLs were 14,582,966 (13,217,174- 15,764,048), with an age-standardized YLLs rate of 1337.02 (1208.87-1445.89). From 1990 to 2021, the AAPC of ASIR for global elderly CRC was 0.13 (0.12 to 0.15), the AAPC of ASPR for global elderly CRC was 0.63 (0.61 to 0.65), the AAPC of ASDR for global elderly CRC was - 0.72 (- 0.74 to- 0.69), the AAPC of Age-standardized DALYs rate for global elderly CRC was - 0.72 (- 0.73 to- 0.69), the AAPC of Age-standardized YLDs rate for global elderly CRC was 0.35 (0.33 to 0.37), the AAPC of Age-standardized YLLs rate for global elderly CRC was - 0.76 (- 0.78 to- 0.74). Projections based on the Bayesian Age-Period-Cohort model indicate that elderly CRC would continue to impose a substantial disease burden through 2025.

Conclusion: In 2021, the global burden of CRC among the elderly remained substantial. Projections to 2050 indicate that the burden of elderly CRC would continue to rise. To mitigate this burden, global efforts must prioritize early detection through expanded screening programs, improved access to treatment, and enhanced public health strategies, particularly in regions with limited healthcare infrastructure.

Keywords: Colorectal cancer; Elderly; Epidemiology; Global burden.

Fig. 1

The global incidence (A), prevalence (B), deaths (C), DALYs (D), YLDs (E) and YLLs (F) of CRC among elderly individuals across different age groups in 2021

Fig. 2

The global incidence (A), prevalence (B), deaths (C), DALYs (D), YLDs (E) and YLLs (F) of CRC in the elderly population across various countries worldwide

Fig. 3

The global incidence (A), prevalence (B), deaths (C), DALYs (D), YLDs (E) and YLLs (F) of CRC among elderly across 21 super SDI regions in 2021

Fig. 4

The global incidence (A), prevalence (B), deaths (C), DALYs (D), YLDs (E) and YLLs (F) of CRC among elderly across 5 SDI regions in 2021

Fig. 5

Trends in Age-Standardized incidence (A), prevalence (B), deaths (C), DALYs (D), YLDs (E) and YLLs (F) rates for eldly CRC Globally from 1990 to 2021

Fig. 6

The decomposition analysis results of Age-Standardized incidence (A), prevalence (B), deaths (C), DALYs (D), YLDs (E) and YLLs (F) rates of CRC in the elderly from 1990 to 2021

Fig. 7

The projections of elderly CRC based on the BAPC model, illustrating the predicted incidence (A), prevalence (B), and deaths (C), DALYs (D), YLDs (E) and YLLs (F)