Liu A, Zhuang Z, Li J, Wang Q, Liu S, Fang H, Huang T, Zhou M
China National Center for Food Safety Risk Assessment, Beijing, China.
Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing, China.
Public Health. 2024 May;230:21-28. doi: 10.1016/j.puhe.2023.11.038. Epub 2024 Mar 13.
The objective of this experiment was to evaluate the spatial pattern and temporal trend of colorectal cancer (CRC) burden attributed to dietary risk factors in China from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors study (GBD) 2019.
Numbers and age-standardised rates of deaths, disability-adjusted life years (DALYs) and corresponding average annual percentage change (AAPC) were determined. The joinpoint regression analysis was used to assess the temporal trends of CRC deaths and DALYs from 1990 to 2019.
In China, the number of diet-attributable CRC deaths and DALYs in 2019 were 90.41 (95% uncertainty interval: 65.69, 114.67) and 2234.06 (1609.96, 2831.24) per-1000 population, marking 2.05% and 1.68% annual increases since 1990, respectively. The region with the highest increase in age-standardised rates (ASRs) of diet-related CRC deaths and DALYs was in Taiwan with an AAPC of 2.00% (1.51, 2.48), whereas the highest decline in ASRs of CRC deaths and DALYs was observed in Hong Kong with an AAPC of -0.63% (-0.90, -0.35) (all P < 0.05). Nationally, men suffered higher CRC deaths and DALY burdens attributable to dietary risks than did women. Regarding the specific diet group, diets low in calcium, milk, and whole grains contributed to CRC deaths and DALYs the most.
Diet is an important contributor to increasing CRC burden in China. Necessary measures should be taken to kerb the growing burden attributed to dietary factors, particularly in males and in regions with middle Socio-demographic Index or lower.
本实验的目的是利用2019年全球疾病、伤害及风险因素负担研究(GBD)的数据,评估1990年至2019年中国饮食风险因素所致结直肠癌(CRC)负担的空间模式和时间趋势。
确定死亡人数、伤残调整生命年(DALY)的年龄标准化率以及相应的年均变化百分比(AAPC)。采用Joinpoint回归分析评估1990年至2019年CRC死亡和DALY的时间趋势。
在中国,2019年饮食归因的CRC死亡人数和DALY分别为每1000人口90.41(95%不确定区间:65.69,114.67)和2234.06(1609.96,2831.24),自1990年以来分别以每年2.05%和1.68%的速度增长。饮食相关CRC死亡和DALY年龄标准化率(ASR)增幅最高的地区是台湾,AAPC为2.00%(1.51,2.48),而CRC死亡和DALY的ASR降幅最高的地区是香港,AAPC为-0.63%(-0.90,-0.35)(所有P<0.05)。在全国范围内,男性因饮食风险导致的CRC死亡和DALY负担高于女性。就特定饮食组而言,低钙、低牛奶和低全谷物饮食对CRC死亡和DALY的贡献最大。
饮食是中国CRC负担增加的重要因素。应采取必要措施遏制饮食因素导致的负担不断增加的趋势,特别是在男性以及社会人口统计学指数中等或较低的地区。