Burden of colorectal cancer in China and its provinces from 1990 to 2021:findings from the Global Burden of Disease Study 2021
Objective To understand the burden of colorectal cancer(CRC)in China and its provinces from 1990 to 2021 and provide evidence for the prevention and control measures of CRC.Methods The study utilized data from the Global Burden of Disease(GBD)2021 of China and its provinces and used SAS 9.4 for analysis.It employed indicators including incidence,mortality,and disability-adjusted life years(DALY)to assess the burden of CRC.To identify the temporal trend,joinpoint regression was applied to estimate the average annual percentage change(AAPC)from 1990 to 2021.To investigate the major contributor of changes of mortality across years,national and subnational deaths were decomposed into three components including change due to age structure of population,change due to population growth and change due to age-specific mortality.Results In 2021,the number of incidence,mortality and DALY of CRC in China were 65.83 ten thousand,27.51 ten thousand and 684.84 ten thousand person years,respectively.The age-standardized rates were 31.44/105,13.64/105 and 331.73/105 accordingly.From 1990 to 2021,the number of incidences,deaths,and DALY increased by 315.63％,130.61％and 92.09％respectively in China,with higher growth rates in males(incidences:374.16％;deaths:163.30％;DALY:120.03％)than in females(incidences:241.78％;deaths:89.81％;DALY:54.73％).The age-standardized incidence rate for CRC showed upward trend(AAPC=1.66％,P＜0.05)during study period,and higher increase was observed in males(males:AAPC=2.12％,P＜0.05;females:AAPC=0.94％,P＜0.05).In contrast,the age-standardized rate of mortality and DALY dropped(AAPC values were-0.41％and-0.53％respectively,P＜0.05)with greater decrease observed in females(AAPC values of females were-1.10％and-1.34％respectively,P＜0.05;AAPC values of males were 0.06％and-0.02％respectively,P＞0.05).From 1990 to 2021,the contributions of population aging,population growth,and age-specific mortality to the increase of CRC deaths were 141.90％,20.93％and-32.22％respectively.However,the main contributors for the increase in CRC deaths varied significantly across regions.Conclusion CRC results in severe public-health consequences in China.Population aging is the primary driver of the rising number of CRC deaths at national level.It is essential to understand the epidemiological characteristics and trends of CRC in different regions.Identifying regions with higher risk is crucial to implement measures of prevention and control of CRC,and therefore could enhance the overall health of the Chinese population.
Colorectal cancerGlobal Burden of Disease 2021Temporal trendDeath decompositionRegional variation
NETL
NSTL
万方数据
