Zhu Guangyi, Sun Yilan, Lian Dongbo, Amin Buhe, Xu Guangzhong, Wang Jing, Zhang Nengwei, Wang Dezhong
Surgery Centre of Diabetes Mellitus, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing 100038, China.
Prev Med Rep. 2025 Jul 18;57:103170. doi: 10.1016/j.pmedr.2025.103170. eCollection 2025 Sep.
Quantify global high body mass index (BMI)-linked colorectal cancer death and disability-adjusted life years (DALYs) (1990-2021) using the Global Burden of Disease (GBD) 2021 data, assessing spatiotemporal trends to inform prevention strategies.
Geographic analysis, age-sex stratification, and sociodemographic index (SDI) quintiles evaluated disease distribution. Calculated estimated annual percentage change (EAPC) for trends. Demographic decomposition models quantified the contributions of population aging, epidemiological changes, and growth. Assessed health inequality via the slope inequality index (SII) and concentration index and prevention efficiency with SDI-age-standardized DALYs rate frontier.
Globally from 1990 to 2021, deaths from high BMI-associated colorectal cancer rose from 41,536 to 99,268, with the age-standardized death rate increasing from 1.14 to 1.17. The age-standardized death rate significantly increased in low- and middle-SDI regions while declining in high SDI regions. Disease burden growth was prominent in East and Southeast Asia. Death rates and rates of DALYs were higher in men than in women, and the burden was highest in people aged 60 years or older. Population growth was the primary driver of the increased burden (contributing >60 % to deaths and DALYs), followed by population aging. While health inequality (as measured by the SII) slightly decreased from 42.12 to 39.76, significant socio-demographic disparities persisted.
High BMI-associated colorectal cancer burden escalates in low-middle SDI regions and elderly males. Targeted prevention and healthcare efficiency in low SDI areas are critical.
利用2021年全球疾病负担（GBD）数据，量化1990 - 2021年全球高体重指数（BMI）相关的结直肠癌死亡人数和伤残调整生命年（DALYs），评估时空趋势以指导预防策略。
通过地理分析、年龄 - 性别分层和社会人口指数（SDI）五分位数评估疾病分布。计算趋势的估计年度百分比变化（EAPC）。人口分解模型量化了人口老龄化、流行病学变化和增长的贡献。通过斜率不平等指数（SII）和集中指数评估健康不平等，并通过SDI年龄标准化的DALYs率前沿评估预防效率。
1990年至2021年全球范围内，高BMI相关的结直肠癌死亡人数从41,536人增至99,268人，年龄标准化死亡率从1.14增至1.17。低和中等SDI地区的年龄标准化死亡率显著上升，而高SDI地区则下降。东亚和东南亚地区疾病负担增长显著。男性的死亡率和DALYs率高于女性，60岁及以上人群的负担最高。人口增长是负担增加的主要驱动因素（对死亡和DALYs的贡献超过60%），其次是人口老龄化。虽然健康不平等（以SII衡量）从42.12略有下降至39.76，但显著的社会人口差异仍然存在。
在低 - 中等SDI地区和老年男性中，高BMI相关的结直肠癌负担不断升级。低SDI地区的针对性预防和医疗保健效率至关重要。
