Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, 450014, Henan, China.
Department of Oncology, Guizhou Provincial People's Hospital, Guiyang, 550002, Guizhou, China.
Int J Colorectal Dis. 2020 Jun;35(6):1077-1086. doi: 10.1007/s00384-020-03558-2. Epub 2020 Mar 16.
Knowing the global incidence of colorectal cancer (CRC), by sex and age of onset, is of great importance for understanding the disease burden of CRC.
The CRC incidence data, by cancer site, age of onset, sex, country, and year, were retrieved from the Cancer Incidence in Five Continents Vol. Plus database. Estimated annual percentage changes (EAPC) were calculated to quantify the temporal trends in the CRC age-standardized incidence rate.
Globally, the incidence of late-onset CRC was heterogeneous and remained increasing in most countries. The highest incidence of late-onset colon and rectal cancer was both found in males in Slovakia (156.5/100,000 and 121.5/100,000, respectively). The most pronounced increases were mostly observed in developing countries, such as Brazil (colon cancer: EAPC = 5.87, 95% CI 3.18, 8.63; rectal cancer: EAPC = 4.68; 95% CI 2.78, 6.62). The highest incidence of early-onset colon and rectal cancer was found in females in Switzerland (4.2/100,000) and in males in South Korea (4.6/100,000), respectively. The incidences of early-onset CRC were increased in parts of countries, including countries experiencing a decline in late-onset CRC incidence, such as the USA, Germany, and Australia. The temporal trends of colon cancer were mostly aligned with those of rectal in most countries, independent of sex and age of onset.
The increase of early-onset CRC incidence suggests more prevention initiatives are urgently warranted for young adults in the near future. Targeted and effective prevention measures are still needed among elderly populations.
了解全球结直肠癌（CRC）的发病情况，包括性别和发病年龄，对于了解 CRC 的疾病负担具有重要意义。
从《五大洲癌症发病率》第 X 增补版数据库中检索了按癌症部位、发病年龄、性别、国家和年份划分的 CRC 发病数据。计算了年度百分比变化（EAPC），以量化 CRC 年龄标准化发病率的时间趋势。
全球来看，晚发性 CRC 的发病率存在异质性，且在大多数国家仍呈上升趋势。斯洛伐克男性的晚发性结肠癌和直肠癌发病率最高（分别为 156.5/100,000 和 121.5/100,000）。增幅最明显的主要是发展中国家，如巴西（结肠癌：EAPC=5.87，95%CI 3.18-8.63；直肠癌：EAPC=4.68；95%CI 2.78-6.62）。瑞士女性的早发性结肠癌和直肠癌发病率最高（4.2/100,000），韩国男性的发病率最高（4.6/100,000）。部分国家的早发性 CRC 发病率有所上升，包括美国、德国和澳大利亚等 CRC 晚发发病率下降的国家。大多数国家的结肠癌时间趋势与直肠癌基本一致，而与性别和发病年龄无关。
早发性 CRC 发病率的上升表明，在不久的将来，年轻人需要更积极的预防措施。老年人群仍需要有针对性和有效的预防措施。
