Luo Zilin, Dong Xuesi, Wang Le, Zheng Yadi, Wang Chenran, Xie Jiaxin, Chen Xiaolu, Zhao Liang, Xu Yongjie, Cao Wei, Wang Fei, Du Lingbin, Li Ni
Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Natl Cancer Cent. 2025 Jan 11;5(3):313-321. doi: 10.1016/j.jncc.2025.01.001. eCollection 2025 Jun.
Primary prevention targeting modifiable risk factors would reduce the global burden of colorectal cancer, but the quantitative results are uncertain. We aimed to assess the global burden of colorectal cancer attributed to modifiable lifestyle factors and quantify the potential increase in life expectancy resulting from the elimination of these risk factors.
Based on the Global Burden of Disease Study 2021, we examined colorectal cancer deaths and disability-adjusted life years attributed to modifiable risk factors (including smoking, diet low in whole grains, diet low in milk, diet high in red meat, diet low in calcium, diet high in processed meat, and diet low in fiber) at the global, regional, and national levels from 1990 to 2021. The abridged period life table method was utilized to quantify the potential gain in life expectancy from eliminating these risk factors.
Globally in 2021, 57.1 % of colorectal cancer deaths and 56.4 % of disability-adjusted life years were preventable, with rates of 7.55 (4.94-9.64) and 174.67 (114.54-222.24) per 100,000 population, respectively. The modifiable burden has diminished in the high, high-middle, and low socio-demographic index quintiles and remained steady in the middle one. However, there is a concerning increase in the low-middle one. In 2021, the elimination of global colorectal cancer attributed to modifiable factors would increase the life expectancy for males and females by 0.107 and 0.109 years, respectively.
Our results quantitatively demonstrate the substantial burden reduction in colorectal cancer and the significant gain in life expectancy that can be achieved by eliminating modifiable lifestyle factors.
针对可改变的风险因素进行一级预防可减轻全球结直肠癌负担，但定量结果尚不确定。我们旨在评估可改变的生活方式因素导致的全球结直肠癌负担，并量化消除这些风险因素后预期寿命的潜在增加。
基于《2021年全球疾病负担研究》，我们在全球、区域和国家层面研究了1990年至2021年期间可改变的风险因素（包括吸烟、全谷物摄入量低的饮食、牛奶摄入量低的饮食、红肉摄入量高的饮食、钙摄入量低的饮食、加工肉类摄入量高的饮食以及膳食纤维摄入量低的饮食）导致的结直肠癌死亡人数和伤残调整生命年。采用简略寿命表法量化消除这些风险因素后预期寿命的潜在增加。
2021年全球范围内，57.1%的结直肠癌死亡和56.4%的伤残调整生命年是可预防的，每10万人中的发生率分别为7.55（4.94 - 9.64）和174.67（114.54 - 222.24）。在社会人口学指数高、高中等和低五分位数中，可改变的负担有所减轻，在中等五分位数中保持稳定。然而，在中低五分位数中有令人担忧的增加。2021年，消除全球可改变因素导致的结直肠癌将使男性和女性的预期寿命分别增加0.107年和0.109年。
我们的结果定量地证明了消除可改变的生活方式因素可大幅减轻结直肠癌负担并显著提高预期寿命。
