National Center for Chronic and Noncommunicable Disease Control and Prevention, China CDC, Beijing, China.
Hebei Key Laboratory of Environment and Human Health, Department of Epidemiology and Statistic, Hebei Medical University, Shijiazhuang, Hebei, China.
J Hum Nutr Diet. 2021 Feb;34(1):233-242. doi: 10.1111/jhn.12836. Epub 2020 Nov 19.
Colorectal cancer (CRC) has emerged as a major public health concern. However, little is known about the burden attributable to specific risk factors. The present study aimed to estimate the temporal trends and geographical variation of CRC burden attributable to a diet low in milk in China.
Following the general analytic strategy used in the 2017 Global Burden of Disease study, we assessed the age-, sex-, and province-specific mortality and disability-adjusted life-years (DALYs) of CRC caused by a diet low in milk in China from 1990 to 2017.
In 2017, a diet low in milk contributed 32 032 [95% uncertainty interval (UI) = 11 350-53 806] deaths and 726 710 (95% UI = 256 651-1 218 153) DALYs for CRC with a population attributable fraction of 17.1%. The age-standardised mortality and DALY rates per 100 000 were 1.7 (95% UI = 0.6-2.9) and 36.8 (95% UI = 13.0-61.7), respectively. An upward trend with age in rates of mortality and DALYs was observed. Males had higher age-standardised rates than females. The number of deaths and DALYs increased significantly from 1990 to 2017, whereas the corresponding age-standardised rates showed relatively stable trends. In 2017, Hunan and Liaoning were ranked as the top two provinces in terms of disease burden. Socio-demographic index had a weak correlation with the age-standardised mortality (r = 0.348, P = 0.047).
The present study shows a substantial increase in the CRC burden attributable to a diet low in milk over the past three decades. Greater priority in CRC prevention should be given to males and the elderly population throughout China, particularly in less-developed provinces.
结直肠癌（CRC）已成为一个主要的公共卫生关注点。然而，对于归因于特定风险因素的负担知之甚少。本研究旨在估计中国低牛奶饮食导致 CRC 的时间趋势和地理变化。
本研究遵循 2017 年全球疾病负担研究中使用的一般分析策略，评估了 1990 年至 2017 年中国低牛奶饮食导致 CRC 的年龄、性别和省级死亡率和伤残调整生命年（DALYs）。
2017 年，低牛奶饮食导致 CRC 死亡 32032 人（95%置信区间 [95%CI] = 11350-53806），DALY 为 726710 人（95%CI = 256651-1218153），人群归因分数为 17.1%。标准化死亡率和每 100000 人 DALY 率分别为 1.7（95%CI = 0.6-2.9）和 36.8（95%CI = 13.0-61.7）。死亡率和 DALY 率随年龄呈上升趋势。男性的标准化死亡率和 DALY 率高于女性。1990 年至 2017 年期间，死亡人数和 DALY 均显著增加，而相应的标准化率呈相对稳定的趋势。2017 年，湖南和辽宁的疾病负担最高。社会人口指数与标准化死亡率的相关性较弱（r = 0.348，P = 0.047）。
本研究表明，过去三十年来，低牛奶饮食导致 CRC 的负担显著增加。中国应更加重视男性和老年人群的 CRC 预防，特别是在欠发达省份。
