Department of Surgery, SoM, Addis Ababa University, P.Box:1176, Addis Ababa, Ethiopia.
Department of Surgery, Debre Tabor Hospital, Debre Tabor, Ethiopia.
BMC Gastroenterol. 2022 Apr 25;22(1):204. doi: 10.1186/s12876-022-02275-0.
Colorectal cancer plays significant role in morbidity, mortality and economic cost in Africa.
To investigate the burden and trends of incidence, mortality, and disability-adjusted life-years (DALYs) of colorectal cancer in Africa from 2010 to 2019.
This study was conducted according to Global Burden of Disease (GBD) 2019 analytic and modeling strategies. The recent GBD 2019 study provided the most updated and compressive epidemiological evidence of cancer incidence, mortality, years lived with disability (YLDs), years of life lost (YLLs), and DALYs.
In 2019, there were 58,000 (95% UI: 52,000-65,000), 49,000 (95% UI: 43,000-54,000), and 1.3 million (95% UI: 1.14-1.46) incident cases, deaths and DALYs counts of colorectal cancer respectively in Africa. Between 2010 and 2019, incidence cases, death, and DALY counts of CRC were significantly increased by 48% (95% UI: 34-62%), 41% (95% UI: 28-55%), and 41% (95% UI: 27-56%) respectively. Change of age-standardised rates of incidence, death and DALYs were increased by 11% (95% UI: 1-21%), 6% (95% UI: - 3 to 16%), and 6% (95% UI: - 5 to 16%) respectively from 2010 to 2019. There were marked variations of burden of colorectal cancer at national level from 2010 to 2019 in Africa.
Increased age-standardised death rate and DALYs of colorectal cancer indicates low progress in CRC standard care-diagnosis and treatment, primary prevention of modifiable risk factors and implementation of secondary prevention modality. This serious effect would be due to poor cancer infrastructure and policy, low workforce capacity, cancer center for diagnosis and treatment, low finical security and low of universal health coverage in Africa.
结直肠癌在非洲的发病率、死亡率和经济负担方面起着重要作用。
调查 2010 年至 2019 年非洲结直肠癌的发病、死亡和伤残调整生命年(DALY)负担和趋势。
本研究按照全球疾病负担(GBD)2019 分析和建模策略进行。最近的 GBD 2019 研究提供了癌症发病率、死亡率、失能生命年(YLDs)、死亡生命年(YLLs)和 DALY 最具时效性和全面性的流行病学证据。
2019 年,非洲结直肠癌的发病、死亡和 DALY 分别为 5.8 万例(95% UI:5.2-6.5 万例)、4.9 万例(95% UI:4.3-5.4 万例)和 130 万例(95% UI:1.14-1.46 万例)。2010 年至 2019 年,CRC 的发病例数、死亡例数和 DALY 分别显著增加了 48%(95% UI:34-62%)、41%(95% UI:28-55%)和 41%(95% UI:27-56%)。发病率、死亡率和 DALY 的年龄标准化率变化分别增加了 11%(95% UI:1-21%)、6%(95% UI:-3-16%)和 6%(95% UI:-5-16%)。2010 年至 2019 年,非洲各国结直肠癌负担存在显著差异。
结直肠癌标准化治疗的诊断和治疗、可改变风险因素的初级预防和二级预防模式的实施方面取得的进展缓慢,导致结直肠癌死亡率和 DALY 年龄标准化率的上升。这种严重影响归因于非洲癌症基础设施和政策较差、劳动力能力低、诊断和治疗癌症中心、金融保障水平低和全民健康覆盖水平低。