1990年至2021年全球、区域和国家早发性结直肠癌负担：基于2021年全球疾病负担研究的系统分析

Global, regional, and national burden of early-onset colorectal cancer from 1990 to 2021: a systematic analysis based on the global burden of disease study 2021.

作者信息

Meng Yang, Tan Zongbiao, Zhen Junhai, Xiao Di, Cai Liwei, Dong Weiguo, Chen Changzheng

机构信息

Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, 430060, China.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, 430060, China.

出版信息

BMC Med. 2025 Jan 21;23(1):34. doi: 10.1186/s12916-025-03867-9.

BACKGROUND

To provide estimates and trends for burdens of early-onset colorectal cancer (EOCRC) from 1990 to 2021 at the global, regional, and national levels, and to provide projections of EOCRC burden through 2030.

METHODS

A trend analysis based on the Global Burden of Diseases 2021. The joinpoint regression model was used to analyze the temporal trends on EOCRC burden by calculating the corresponding average annual percent changes (AAPCs). A decomposition analysis was used to understand the drivers of the changes in EOCRC burden. The relationship between socio-demographic index (SDI) and disease burden was assessed by the concentration index of inequality. In addition, we constructed a Bayesian age-period-cohort model to predict the burden of EOCRC worldwide from 2022 to 2030.

RESULTS

Globally, the burden of EOCRC increased significantly between 1990 and 2021, with the incidence rising from 5.43/100000 to 6.13/100000 (AAPC = 0.39), and the prevalence increasing from 29.65/100000 to 38.86/100000 (AAPC = 0.87). Over the same period, the death rate decreased from 2.98/100000 to 2.30/100000 (AAPC = - 0.84), whereas the disability-adjusted life-year (DALY) decreased from 148.46/100000 to 115.42/100000 (AAPC = - 0.82). In 2021, East Asia and China had the highest burden of EOCRC regionally and nationally. Decomposition analysis indicated the increase in EOCRC burden was mainly driven by population growth. The concentration index revealed that high-SDI countries had a greater burden of EOCRC than low-SDI countries. The global incidence and prevalence of EOCRC will rise continuously from 2022 to 2030.

CONCLUSIONS

Between 1990 and 2021, the incidence and prevalence of EOCRC have escalated, whereas the death rate and DALY rate have declined. The burden varied with sex, SDI, and geographical locations. Given the rising trend of EOCRC burden, coordinated efforts are needed to reduce the burden posed by this malignancy.

背景

提供1990年至2021年全球、区域和国家层面早发性结直肠癌（EOCRC）负担的估计和趋势，并预测到2030年EOCRC的负担情况。

方法

基于《2021年全球疾病负担》进行趋势分析。采用连接点回归模型，通过计算相应的年均变化百分比（AAPC）来分析EOCRC负担的时间趋势。使用分解分析来了解EOCRC负担变化的驱动因素。通过不平等集中指数评估社会人口指数（SDI）与疾病负担之间的关系。此外，我们构建了贝叶斯年龄-时期-队列模型，以预测2022年至2030年全球EOCRC的负担。

结果

在全球范围内，1990年至2021年期间EOCRC负担显著增加，发病率从5.43/10万上升至6.13/10万（AAPC = 0.39），患病率从29.65/10万增加到38.86/10万（AAPC = 0.87）。同一时期，死亡率从2.98/10万降至2.30/10万（AAPC = -0.84），而伤残调整生命年（DALY）从148.46/10万降至115.42/10万（AAPC = -0.82）。2021年，东亚和中国在区域和国家层面的EOCRC负担最高。分解分析表明，EOCRC负担增加主要由人口增长驱动。集中指数显示，高SDI国家的EOCRC负担高于低SDI国家。2022年至2030年，全球EOCRC的发病率和患病率将持续上升。