Huang Tianze, Qiu Jianfu, Wang Changhao, Ma Xiang, Liu Duo, Cai Jian
Department of Colorectal Surgery, Shenzhen Second People's Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen, China.
Medical Innovation Technology Transformation Center of Shenzhen Second People's Hospital, Shenzhen, China.
Cancer Control. 2025 Jan-Dec;32:10732748251341524. doi: 10.1177/10732748251341524. Epub 2025 May 8.
BackgroundThe incidence and prevalence of early-onset colorectal cancer (EO-CRC), defined as colorectal cancer diagnosed before the age of 50, are increasing globally. However, the current status and trends of the disease burden of EO-CRC in China, including incidence, prevalence, mortality, and disability-adjusted life-years (DALYs), are not well understood. This study aimed to analyze the epidemiological trends of EO-CRC in China from 1990 to 2021 and to project its future burden.MethodsWe analyzed data from the Global Burden of Disease (GBD) 2021 study to assess the trends in incidence, prevalence, mortality, and DALYs of EO-CRC in China from 1990 to 2021. Joinpoint regression analysis was used to identify significant changes in trends. Age-period-cohort (APC) analysis was conducted to disentangle the effects of age, period, and birth cohort. The Bayesian APC model was employed to project the burden of EO-CRC up to 2036.ResultsFrom 1990 to 2021, the absolute number of EO-CRC incident and prevalent cases in China increased substantially. The age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) also rose significantly, with an accelerated increase after 2007 in men and after 2015 in women. In contrast, the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (AS-DALYs) generally declined; however, a concerning reversal of this trend has been observed in recent years. Incidence, prevalence, mortality and DALYs rates all showed significant age, period, and cohort effects. Projections indicate that ASIR and ASPR will continue to rise until 2036, especially in males, and the disparity in disease burden between men and women is expected to widen.ConclusionThe disease burden of EO-CRC in China has increased significantly and is rising rapidly, particularly among males. Further research is essential to fully understand the factors contributing to the increased incidence of EO-CRC and to develop effective mitigation strategies.
背景
早发性结直肠癌（EO-CRC）定义为在50岁之前确诊的结直肠癌，其发病率和患病率在全球范围内都在上升。然而，中国EO-CRC疾病负担的现状和趋势，包括发病率、患病率、死亡率和伤残调整生命年（DALYs），目前尚不清楚。本研究旨在分析1990年至2021年中国EO-CRC的流行病学趋势，并预测其未来负担。
方法
我们分析了全球疾病负担（GBD）2021研究中的数据，以评估1990年至2021年中国EO-CRC的发病率、患病率、死亡率和DALYs趋势。采用Joinpoint回归分析来确定趋势的显著变化。进行年龄-时期-队列（APC）分析以区分年龄、时期和出生队列的影响。采用贝叶斯APC模型预测到2036年EO-CRC的负担。
结果
从1990年到
