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Abstract
Background: Colorectal cancer is one of the most common malignant tumors of the digestive system worldwide. Thus, summarizing and analyzing the global epidemiological characteristics of colorectal cancer and the risk factors associated with its incidence can further guide the prevention, control, and clinical diagnosis and treatment of colorectal cancer. In this study, we comprehensively assessed the global, regional and national burden of Colorectal cancer (CRC) in incidence, deaths, prevalence and disability adjusted life year (DALYs) based on the Global Burden of Disease Study GBD) 2021.
Methods: The data for this study are extracted from the GBD 2021. We used data on CRC incidence, prevalence, and DALYs from 1990 to 2021 to evaluate the burden of CRC in the past 30 years. According to the 204 countries and territories and the sociodemographic index (SDI), the estimates were demonstrated along with the estimated annual percentage change (EAPC). We further applied an autoregressive integrated moving average (ARIMA) model and exponential smoothing (ES) model to predict the disease burden for the period 2021-2050. We also used Bayesian age-period-cohort (BAPC) model to predict the PCOS burden in the next 20 years.
Findings: From 1990 to 2021, the age-standardized deaths rate decreased by 20%, age-standardized DALYs rate decreased by 21%, age-standardized prevalence rate increased by 25%, and age-standardized incidence rate of CRC increased by 7%. Netherlands (69.80 [62.21–76.79] per 100,000), Monaco (68.33 [54.05–83.19] per 100,000), and Bermuda (61.79 [51.46–77.11] per 100,000) had the highest age-standardized incidence rates, while Uruguay (27.46 [24.25–30.91] per 100,000), Brunei (26.01 [21.73–31.13] per 100,000), and Bulgaria (25.71 [20.96–30.73] per 100,000) had the highest age-standardized death rates. Globally, diet low in whole grains (17.70%), diet low in milk (15.16%), diet high in red meat (14.54%), and high body-mass index (9.56%) were the main contributors to colorectal cancer DALYs in 2021.
Interpretation: The present study revealed that the disease burden of CRC is still severe. The fast-rising burden in the low-SDI and middle-SDI countries (including low-middle, middle, and high-middle SDI) calls for strengthening health education, establishing appropriate early screening strategies, promoting standardized treatment, and developing a CRC prevention and control system that fits the conditions of each country are crucial measures to face this global challenge.
Funding: This study was supported by the Special Research Project on Improving the Evidence Level of Traditional Chinese Medicine Clinical Evidence by the China Academy of Chinese Medical Sciences (grant nos. XYZX020107).
Declaration of Interest: The authors declare that they have no competing interests.
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