TY - JOUR
T1 - Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019
T2 - a systematic analysis for the Global Burden of Disease Study 2019
AU - GBD 2019 Colorectal Cancer Collaborators
AU - Sharma, Rajesh
AU - Abbasi-Kangevari, Mohsen
AU - Abd-Rabu, Rami
AU - Abidi, Hassan
AU - Abu-Gharbieh, Eman
AU - Acuna, Juan Manuel
AU - Adhikari, Sangeet
AU - Advani, Shailesh M.
AU - Afzal, Muhammad Sohail
AU - Aghaie Meybodi, Mohamad
AU - Ahinkorah, Bright Opoku
AU - Ahmad, Sajjad
AU - Ahmadi, Ali
AU - Ahmadi, Sepideh
AU - Ahmed, Haroon
AU - Ahmed, Luai A.
AU - Ahmed, Muktar Beshir
AU - Al Hamad, Hanadi
AU - Alahdab, Fares
AU - Alanezi, Fahad Mashhour
AU - Alanzi, Turki M.
AU - Alhalaiqa, Fadwa Alhalaiqa Naji
AU - Alimohamadi, Yousef
AU - Alipour, Vahid
AU - Aljunid, Syed Mohamed
AU - Alkhayyat, Motasem
AU - Almustanyir, Sami
AU - Al-Raddadi, Rajaa M.
AU - Alvand, Saba
AU - Alvis-Guzman, Nelson
AU - Amini, Saeed
AU - Ancuceanu, Robert
AU - Anoushiravani, Amir
AU - Anoushirvani, Ali Arash
AU - Ansari-Moghaddam, Alireza
AU - Arabloo, Jalal
AU - Aryannejad, Armin
AU - Asghari Jafarabadi, Mohammad
AU - Athari, Seyyed Shamsadin
AU - Ausloos, Floriane
AU - Ausloos, Marcel
AU - Awedew, Atalel Fentahun
AU - Awoke, Mamaru Ayenew
AU - Ayana, Tegegn Mulatu
AU - Azadnajafabad, Sina
AU - Azami, Hiva
AU - Azangou-Khyavy, Mohammadreza
AU - Azari Jafari, Amirhossein
AU - Badiye, Ashish D.
AU - Bagherieh, Sara
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2022/7
Y1 - 2022/7
N2 - BACKGROUND: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades.METHODS: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer.FINDINGS: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019.INTERPRETATION: The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions.FUNDING: Bill & Melinda Gates Foundation.
AB - BACKGROUND: Colorectal cancer is the third leading cause of cancer deaths worldwide. Given the recent increasing trends in colorectal cancer incidence globally, up-to-date information on the colorectal cancer burden could guide screening, early detection, and treatment strategies, and help effectively allocate resources. We examined the temporal patterns of the global, regional, and national burden of colorectal cancer and its risk factors in 204 countries and territories across the past three decades.METHODS: Estimates of incidence, mortality, and disability-adjusted life years (DALYs) for colorectal cancer were generated as a part of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019 by age, sex, and geographical location for the period 1990-2019. Mortality estimates were produced using the cause of death ensemble model. We also calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer.FINDINGS: Globally, between 1990 and 2019, colorectal cancer incident cases more than doubled, from 842 098 (95% uncertainty interval [UI] 810 408-868 574) to 2·17 million (2·00-2·34), and deaths increased from 518 126 (493 682-537 877) to 1·09 million (1·02-1·15). The global age-standardised incidence rate increased from 22·2 (95% UI 21·3-23·0) per 100 000 to 26·7 (24·6-28·9) per 100 000, whereas the age-standardised mortality rate decreased from 14·3 (13·5-14·9) per 100 000 to 13·7 (12·6-14·5) per 100 000 and the age-standardised DALY rate decreased from 308·5 (294·7-320·7) per 100 000 to 295·5 (275·2-313·0) per 100 000 from 1990 through 2019. Taiwan (province of China; 62·0 [48·9-80·0] per 100 000), Monaco (60·7 [48·5-73·6] per 100 000), and Andorra (56·6 [42·8-71·9] per 100 000) had the highest age-standardised incidence rates, while Greenland (31·4 [26·0-37·1] per 100 000), Brunei (30·3 [26·6-34·1] per 100 000), and Hungary (28·6 [23·6-34·0] per 100 000) had the highest age-standardised mortality rates. From 1990 through 2019, a substantial rise in incidence rates was observed in younger adults (age <50 years), particularly in high Socio-demographic Index (SDI) countries. Globally, a diet low in milk (15·6%), smoking (13·3%), a diet low in calcium (12·9%), and alcohol use (9·9%) were the main contributors to colorectal cancer DALYs in 2019.INTERPRETATION: The increase in incidence rates in people younger than 50 years requires vigilance from researchers, clinicians, and policy makers and a possible reconsideration of screening guidelines. The fast-rising burden in low SDI and middle SDI countries in Asia and Africa calls for colorectal cancer prevention approaches, greater awareness, and cost-effective screening and therapeutic options in these regions.FUNDING: Bill & Melinda Gates Foundation.
KW - Adult
KW - Colorectal Neoplasms/epidemiology
KW - Early Detection of Cancer
KW - Global Burden of Disease
KW - Humans
KW - Middle Aged
KW - Quality-Adjusted Life Years
KW - Risk Factors
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U2 - 10.1016/S2468-1253(22)00044-9
DO - 10.1016/S2468-1253(22)00044-9
M3 - Article
C2 - 35397795
AN - SCOPUS:85128844137
SN - 2468-1253
VL - 7
SP - 627
EP - 647
JO - The Lancet Gastroenterology and Hepatology
JF - The Lancet Gastroenterology and Hepatology
IS - 7
ER -