Luo Shiyin, Gong Jichun, Zhu Youwen, Wang Liqun, Zhang Kun
Department of General Surgery, Fuzhou First General Hospital Affiliated with Fujian Medical University, Fuzhou, China.
BMC Gastroenterol. 2025 Aug 9;25(1):570. doi: 10.1186/s12876-025-04184-4.
BACKGROUND: Colorectal Cancer (CRC) is highly prevalent among the elderly (Aged > 60 Years). Investigating the global epidemiological trends of colorectal cancer in elderly patients can aid in developing targeted prevention and control measures. METHODS: The epidemiological data on CRC in the elderly were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, encompassing annual estimates from 1990 to 2021. The acquired metrics included incidence, prevalence, deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs). We analyzed temporal trends of these diverse disease burden indicators for CRC in the elderly population. Furthermore, the Bayesian age-period-cohort (BAPC) model was employed to project future the elderly CRC burden at both national and regional levels. RESULTS: In 2021, the global elderly CRC had a total incidence of 1,617,011 (1,447,212-1,754,348), with an age-standardized incidence rate (ASIR) of 149.16 (133.11-161.91). The total prevalence was 8,079,970 (7,332,761-8,727,386), with an age-standardized prevalence rate (ASPR) of 737.47 (668.26-796.77). Total deaths numbered 827,471 (736,233-897,443), with an age-standardized death rate (ASDR) of 77.51 (68.71-84.13). Total DALYs were 15,347,705 (13,913,323- 16,592,781), with an age-standardized DALYs rate of 1407.18 (1272.56-1522.03). Total YLDs were 764,739 (562,029-991,490), with an age-standardized YLDs rate of 70.16 (51.55-90.93). Total YLLs were 14,582,966 (13,217,174- 15,764,048), with an age-standardized YLLs rate of 1337.02 (1208.87-1445.89). From 1990 to 2021, the AAPC of ASIR for global elderly CRC was 0.13 (0.12 to 0.15), the AAPC of ASPR for global elderly CRC was 0.63 (0.61 to 0.65), the AAPC of ASDR for global elderly CRC was - 0.72 (- 0.74 to- 0.69), the AAPC of Age-standardized DALYs rate for global elderly CRC was - 0.72 (- 0.73 to- 0.69), the AAPC of Age-standardized YLDs rate for global elderly CRC was 0.35 (0.33 to 0.37), the AAPC of Age-standardized YLLs rate for global elderly CRC was - 0.76 (- 0.78 to- 0.74). Projections based on the Bayesian Age-Period-Cohort model indicate that elderly CRC would continue to impose a substantial disease burden through 2025. CONCLUSION: In 2021, the global burden of CRC among the elderly remained substantial. Projections to 2050 indicate that the burden of elderly CRC would continue to rise. To mitigate this burden, global efforts must prioritize early detection through expanded screening programs, improved access to treatment, and enhanced public health strategies, particularly in regions with limited healthcare infrastructure.
背景：结直肠癌（CRC）在老年人（年龄>60岁）中高度流行。调查老年患者结直肠癌的全球流行病学趋势有助于制定有针对性的预防和控制措施。 方法：老年结直肠癌的流行病学数据来自《2021年全球疾病、伤害和危险因素负担研究》（GBD 2021），涵盖1990年至2021年的年度估计数据。获取的指标包括发病率、患病率、死亡人数、伤残调整生命年（DALYs）、带病生存年数（YLDs）和生命损失年数（YLLs）。我们分析了老年人群中结直肠癌这些不同疾病负担指标的时间趋势。此外，采用贝叶斯年龄-时期-队列（BAPC）模型预测国家和地区层面未来的老年结直肠癌负担。 结果：2021年，全球老年结直肠癌总发病率为1,617,011（1,447,212 - 1,754,348），年龄标准化发病率（ASIR）为149.16（133.11 - 161.91）。总患病率为8,079,970（7,332,761 - 8,727,386），年龄标准化患病率（ASPR）为737.47（668.26 - 796.77）。总死亡人数为827,471（736,233 - 897,443），年龄标准化死亡率（ASDR）为77.51（68.71 - 84.13）。总伤残调整生命年为15,347,705（13,913,323 - 16,592,781），年龄标准化伤残调整生命年率为1407.18（1272.56 - 1522.03）。总带病生存年数为764,739（562,029 - 991,490），年龄标准化带病生存年数率为70.16（51.55 - 90.93）。总生命损失年数为14,582,966（13,217,174 - 15,764,048），年龄标准化生命损失年数率为1337.02（1208.87 - 1445.89）。从1990年到2021年，全球老年结直肠癌年龄标准化发病率的年度百分比变化（AAPC）为0.13（0.12至0.15），年龄标准化患病率的AAPC为0.63（0.61至0.65），年龄标准化死亡率的AAPC为 - 0.72（ - 0.74至 - 0.69），年龄标准化伤残调整生命年率的AAPC为 - 0.72（ - 0.73至 - 0.69），年龄标准化带病生存年数率的AAPC为0.35（0.33至0.37），年龄标准化生命损失年数率的AAPC为 - 0.76（ - 0.78至 - 0.74）。基于贝叶斯年龄-时期-队列模型的预测表明，到2025年老年结直肠癌将继续造成巨大的疾病负担。 结论：2021年，全球老年结直肠癌负担仍然很重。到2050年的预测表明，老年结直肠癌负担将继续上升。为减轻这一负担，全球必须优先通过扩大筛查计划、改善治疗可及性和加强公共卫生策略来进行早期检测，特别是在医疗保健基础设施有限的地区。
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