Kang Liangyu, Yan Wenxin, Jing Wenzhan, He Jinyu, Zhang Ning, Liu Min, Liang Wannian
Vanke School of Public Health, Tsinghua University, Beijing 100084, China.
General Surgery, Stanford University, Stanford, CA 94305, USA.
Chin J Cancer Res. 2025 Apr 30;37(2):187-199. doi: 10.21147/j.issn.1000-9604.2025.02.06.
This study aimed to describe the updated disease burden and temporal trends of stomach cancer (SC) and colorectal cancer (CRC), and to explore potential influence factors of the two cancers in the Western Pacific region (WPR).
Estimates of incidence, deaths, and disability-adjusted life years (DALYs) for SC and CRC were obtained from the Global Burden of Disease Study 2021. Trends in age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR) were assessed. A decomposition analysis was conducted to quantify the role of three factors (i.e., population aging, population growth, and epidemiological change) driving DALY changes between 2000 and 2021. Pearson correlation analysis was used to examine the association between cancer burden and Socio-demographic Index (SDI) at the national level in 2021.
In 2021, the WPR accounted for 61.77% of global incident SC cases and 43.07% of global incident CRC cases. From 2000 to 2021, the ASIR, ASMR, and ASDR of SC and the ASMR and ASDR of CRC decreased, whereas the ASIR of CRC increased by an average of 1.32% per year. Among the 31 WPR countries and territories, China had the highest number of incident cases, deaths, and DALYs for both cancers in 2021. Epidemiology change was the primary driver to the reduction of DALYs for SC, while population aging and population growth contributed to the increase of DALYs for CRC. Additionally, ASMR (r=-0.37, P=0.041) and ASDR (r=-0.43, P=0.016) of SC were negatively correlated with SDI in 2021, whereas positive correlations were observed between SDI and ASIR (r=0.74, P<0.001), ASMR (r=0.47, P=0.008), and ASDR (r=0.36, P=0.044) for CRC.
SC and CRC continue to pose considerable public health threats in the WPR. Targeted prevention and control strategies should be prioritized, particularly in high-burden and resource-limited countries.
本研究旨在描述胃癌（SC）和结直肠癌（CRC）的疾病负担更新情况及时间趋势，并探讨西太平洋地区（WPR）这两种癌症的潜在影响因素。
从《2021年全球疾病负担研究》中获取SC和CRC的发病率、死亡率及伤残调整生命年（DALYs）估计值。评估年龄标准化发病率（ASIR）、年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）的趋势。进行分解分析以量化2000年至2021年间推动DALY变化的三个因素（即人口老龄化、人口增长和流行病学变化）的作用。采用Pearson相关分析检验2021年国家层面癌症负担与社会人口指数（SDI）之间的关联。
2021年，WPR占全球SC新发病例的61.77%和全球CRC新发病例的43.07%。2000年至2021年，SC的ASIR、ASMR和ASDR以及CRC的ASMR和ASDR均下降，而CRC的ASIR平均每年上升1.32%。在WPR的31个国家和地区中，2021年中国这两种癌症的新发病例、死亡病例和DALYs数量均最多。流行病学变化是SC的DALYs减少的主要驱动因素，而人口老龄化和人口增长导致CRC的DALYs增加。此外，2021年SC的ASMR（r=-0.37，P=0.041）和ASDR（r=-0.43，P=0.016）与SDI呈负相关，而CRC的SDI与ASIR（r=0.74，P<0.001）、ASMR（r=0.47，P=0.008）和ASDR（r=0.36，P=0.044）呈正相关。
SC和CRC在WPR地区继续构成重大的公共卫生威胁。应优先制定有针对性的预防和控制策略，特别是在高负担和资源有限的国家。
