Yang Mei, Huang Gansheng, Jiang Feng, Guo Zaijin
The Eighth Hospital of Wuhan, Wuhan, China.
Front Nutr. 2025 Aug 7;12:1592425. doi: 10.3389/fnut.2025.1592425. eCollection 2025.
INTRODUCTION: Colorectal cancer is a highly prevalent and significantly lethal digestive malignancy worldwide. This study aims to reveal the evolution of the disease burden of CRC associated with a low-grain diet from 1990 to 2021, to predict future trends, and to provide a scientific basis for differentiated prevention and control strategies. METHODS: The study integrated GBD 2021 data covering 204 countries and territories to assess the disease burden of CRC associated with a low-grain diet by the number of deaths, disability-adjusted life-years (DALYs), age-standardized mortality rates (ASMR), and Age-standardized DALYs rates (ASDR). Trends were quantified using Estimated Annual Percentage Change (EAPC) and disease burden was projected to 2050 using Bayesian Age-Period-Cohort (BAPC) modeling. Decomposition analyses explored the impact of population growth, aging, and epidemiologic changes on burden. RESULTS: Between 1990 and 2021, the number of CRC deaths associated with a low proportion of whole grain diets worldwide increased by 82.94%, and disability adjusted life years increased by 70.3%. There is significant heterogeneity between regions: regions with high Social Population Index (SDI) have the highest decrease rate, while regions with low to medium SDI have the fastest increase rate. Age analysis shows that the disease burden is highest in the 50-85 age group, with males having a significantly higher risk than females. The BAPC model predicts that by 2050, global ASMR and ASDR will further decline, and decomposition analysis shows that population growth is the main reason for the increase in burden. CONCLUSION: Age-standardized mortality rates and ASDR for CRC due to low whole grain diets declined globally between 1990 and 2021, but the absolute number of cases continues to increase. Low whole grain diet is an important modifiable factor in the disease burden of CRC, with significant age, sex, and regional heterogeneity in its impact. Bayesian BAPC model predictions showed a decreasing trend in ASMR and ASDR for colorectal cancer disease burden associated with low grain diets, but the absolute burden continued to increase due to increased aging. Decomposition analyses showed that population growth was the main cause of the increasing burden.
引言：结直肠癌是全球一种高度流行且致死率极高的消化系统恶性肿瘤。本研究旨在揭示1990年至2021年期间与低谷物饮食相关的结直肠癌疾病负担演变情况，预测未来趋势，并为差异化的预防和控制策略提供科学依据。 方法：该研究整合了涵盖204个国家和地区的全球疾病负担研究（GBD）2021数据，通过死亡人数、伤残调整生命年（DALY）、年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）来评估与低谷物饮食相关的结直肠癌疾病负担。使用估计年度百分比变化（EAPC）对趋势进行量化，并使用贝叶斯年龄-时期-队列（BAPC）模型预测到2050年的疾病负担。分解分析探讨了人口增长、老龄化和流行病学变化对负担的影响。 结果：1990年至2021年期间，全球范围内与全谷物饮食比例低相关的结直肠癌死亡人数增加了82.94%，伤残调整生命年增加了70.3%。各地区之间存在显著异质性：社会人口指数（SDI）高的地区下降率最高，而中低SDI地区增长率最快。年龄分析表明，疾病负担在50 - 85岁年龄组最高，男性患病风险显著高于女性。BAPC模型预测，到2050年，全球ASMR和ASDR将进一步下降，分解分析表明人口增长是负担增加的主要原因。 结论：1990年至2021年期间，全球范围内因全谷物饮食比例低导致的结直肠癌年龄标准化死亡率和ASDR有所下降，但病例绝对数持续增加。低全谷物饮食是结直肠癌疾病负担中一个重要的可改变因素，其影响在年龄、性别和地区方面存在显著异质性。贝叶斯BAPC模型预测显示，与低谷物饮食相关的结直肠癌疾病负担的ASMR和ASDR呈下降趋势，但由于老龄化加剧，绝对负担持续增加。分解分析表明人口增长是负担增加的主要原因。
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