归因于可改变风险因素的结直肠癌死亡负担、1990 年至 2019 年的趋势分析及未来预测。
The death burden of colorectal cancer attributable to modifiable risk factors, trend analysis from 1990 to 2019 and future predictions.
机构信息
Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, Department of Medical Oncology, Cancer Institute, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
Department of Medical Geriatrics, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.
出版信息
Cancer Med. 2024 Apr;13(7):e7136. doi: 10.1002/cam4.7136.
BACKGROUND
The death burden attributable to modifiable risk factors is key to colorectal cancer (CRC) prevention. This study aimed to assess the prevalence and regional distribution of attributable CRC death burden worldwide from 1990 to 2019.
METHODS
We extracted data from the Global Burden of Disease Study in 2019 and assessed the mortality, age-standardized death rate (ASDR), population attributable fractions, and time trend in CRC attributable to risk factors by geography, socio-demographic index (SDI) quintile, age, and sex.
RESULTS
Over the past 30 years, from high to low SDI region, the number of deaths increased by 46.56%, 103.55%, 249.64%, 231.89%, 163.11%, and the average annual percentage change (AAPC) for ASDR were -1.06%, -0.01%, 1.32%, 1.19%, and 0.65%, respectively. ASDR in males was 1.88 times than in females in 2019; ASDR in males showed an increasing trend (AAPC 0.07%), whereas ASDR in females showed a decreasing trend (AAPC -0.69%) compared to figures in 1990. In 2019, from high to low SDI region, the 15-49 age group accounted for 3%, 6%, 10%, 11%, and 15% of the total population; dietary and metabolic factors contributed 43.4% and 20.8% to CRC-attributable death worldwide. From high to low SDI region, ASDRs caused by dietary and metabolic factors increased by -23.4%, -5.5%, 25.8%, 29.1%, 13.5%, and 1.4%, 33.3%, 100.8%, 128.4%, 77.7% respectively, compared to 1990.
CONCLUSIONS
The attributable CRC death burden gradually shifted from higher SDI to lower SDI regions. The limitation in males was more significant, and the gap is expected to be further expanded. In lower SDI regions, the death burden tended to affect younger people. The leading cause of CRC-attributable deaths was the inadequate control of dietary and metabolic risk factors.
背景
可改变的风险因素导致的死亡负担是结直肠癌（CRC）预防的关键。本研究旨在评估 1990 年至 2019 年全球归因于 CRC 的死亡负担的流行率和区域分布。
方法
我们从 2019 年全球疾病负担研究中提取数据，并按地理位置、社会人口指数（SDI）五分位数、年龄和性别评估了 CRC 归因于风险因素的死亡率、年龄标准化死亡率（ASDR）、人群归因分数和时间趋势。
结果
在过去的 30 年中，从高 SDI 地区到低 SDI 地区，死亡人数分别增加了 46.56%、103.55%、249.64%、231.89%、163.11%，ASDR 的平均年百分比变化（AAPC）分别为-1.06%、-0.01%、1.32%、1.19%和 0.65%。2019 年，男性的 ASDR 是女性的 1.88 倍；与 1990 年相比，男性的 ASDR 呈上升趋势（AAPC 为 0.07%），而女性的 ASDR 呈下降趋势（AAPC 为-0.69%）。2019 年，从高 SDI 地区到低 SDI 地区，15-49 岁年龄组占全球总人口的 3%、6%、10%、11%和 15%；饮食和代谢因素对全球 CRC 归因死亡的贡献率分别为 43.4%和 20.8%。从高 SDI 地区到低 SDI 地区，饮食和代谢因素导致的 ASDR 分别下降了-23.4%、-5.5%、25.8%、29.1%、13.5%和 1.4%、33.3%、100.8%、128.4%、77.7%，与 1990 年相比。
结论
归因于 CRC 的死亡负担逐渐从高 SDI 地区转移到低 SDI 地区。男性的局限性更为显著，差距预计将进一步扩大。在低 SDI 地区，死亡负担倾向于影响年轻人。CRC 归因死亡的主要原因是饮食和代谢危险因素的控制不足。
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