Zhang Tao, Guo Yuchen, Qiu Binxu, Dai Xianyu, Wang Yifei, Cao Xueyuan
Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China.
Department of Urology, The First Hospital of Jilin University, Changchun, Jilin, China.
Front Oncol. 2025 Jan 16;14:1466159. doi: 10.3389/fonc.2024.1466159. eCollection 2024.
Colorectal cancer (CRC) is a common malignancy with notable recent shifts in its burden distribution. Current data on CRC burden can guide screening, early detection, and treatment strategies for efficient resource allocation.
This study utilized data from the latest Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study. Initially, a series of descriptive statistics were performed on the incident cases, deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of CRC. Percentage changes and average annual percentage changes (AAPC) were then calculated to understand the trends in CRC disease burden. Decomposition and frontier analyses were conducted, and finally, the Bayesian age-period-cohort (BAPC) model was used to predict changes in ASRs up to 2040.
The GBD 2021 estimates indicate a significant increase in the global incident cases, deaths, and DALYs of CRC from 1990 to 2021. The age-standardized incidence rate (ASIR) increased (AAPC: 0.2), while the age-standardized mortality rate (ASMR) (AAPC: -0.72) and age-standardized DALYs rate (AAPC: -0.73) decreased. Males bore a higher disease burden than females, though the trends in disease burden changes were similar for both sexes. Although developed regions had higher incident cases, deaths, and DALYs, they showed more significant declines in ASRs. Decomposition analysis revealed that population growth and aging were the primary drivers of the increased disease burden. Frontier analysis showed that as the Socio-demographic Index increased, the disparity in CRC ASRs among countries widened, with developed regions having greater potential to reduce these rates. The By 2040, the BAPC model projects significant declines in global ASMR and age-standardized DALYs rates, while ASIR is expected to decrease in females but increase in males and across both sexes.
CRC remains a significant public health issue with regional and gender differences, necessitating region- and population-specific prevention strategies.
结直肠癌（CRC）是一种常见的恶性肿瘤，其负担分布最近有显著变化。目前关于结直肠癌负担的数据可指导筛查、早期检测和治疗策略，以实现有效的资源分配。
本研究利用了最新的全球疾病、伤害及风险因素负担（GBD）研究的数据。首先，对结直肠癌的发病病例、死亡人数、伤残调整生命年（DALYs）和年龄标准化率（ASRs）进行了一系列描述性统计。然后计算百分比变化和平均年度百分比变化（AAPC），以了解结直肠癌疾病负担的趋势。进行了分解分析和前沿分析，最后，使用贝叶斯年龄-时期-队列（BAPC）模型预测到2040年ASRs的变化。
GBD 2021估计显示，1990年至2021年期间，全球结直肠癌的发病病例、死亡人数和DALYs显著增加。年龄标准化发病率（ASIR）上升（AAPC：0.2），而年龄标准化死亡率（ASMR）（AAPC：-0.72）和年龄标准化DALYs率（AAPC：-0.73）下降。男性的疾病负担高于女性，尽管两性疾病负担变化趋势相似。虽然发达地区的发病病例、死亡人数和DALYs较高，但它们的ASRs下降更为显著。分解分析表明，人口增长和老龄化是疾病负担增加的主要驱动因素。前沿分析表明，随着社会人口指数的增加，各国结直肠癌ASRs的差距扩大，发达地区降低这些比率的潜力更大。到2040年，BAPC模型预测全球ASMR和年龄标准化DALYs率将显著下降，而ASIR预计在女性中下降，但在男性中上升，在两性中均上升。
结直肠癌仍然是一个重大的公共卫生问题，存在地区和性别差异，需要针对特定地区和人群制定预防策略。
