Data Sheet 5_The global, regional, and national burden of colorectal cancer and its attributable risk factors in 204 countries and territories, 1990-2021: a systematic analysis for the global burden of disease study 2021.pdf

BackgroundColorectal cancer (CRC) is among the leading causes of cancer-related mortality worldwide. This study aimed to assess the global burden of CRC across 204 countries and territories from 1990 to 2021, and identify its attributable risk factors.
MethodsEstimates of CRC incidence, mortality, and disability-adjusted life years (DALYs) were derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, stratified by age, sex, and geographical region over the 1990–2021 period. Additionally, DALYs attributable to risk factors with established causal links to CRC were calculated.
Results100,000 population (95% uncertainty interval [UI]: 25.36–29.90), mortality rate 13.23 per 100,000 (95% UI: 12.04–14.19), and DALY rate 309.21 per 100,000 (95% UI: 287.52–331.52). The number of new CRC cases increased from 916,583 in 1990 to 2,194,143 in 2021. The age-standardized incidence rate (ASIR) rose from 24.0 to 25.6 per 100,000. High SDI (Socio-demographic Index) regions had the highest ASIR (40.5 per 100,000 in 2021), while low SDI regions had the lowest (7.4 per 100,000 in 2021). Between 1990 and 2021, the global age-standardized mortality rate (ASDR) decreased from 15.6 to 12.4 per 100,000, and the age-standardized DALY rate declined from 357.3 to 283.2 per 100,000. However, this reduction was uneven across SDI regions. Key risk factors included behavioral and metabolic factors, among which a diet low in whole grains significantly increased CRC incidence.
ConclusionFrom 1990 to 2021, the global CRC burden increased significantly, with notable variations across SDI regions. While high SDI regions made progress in reducing mortality and DALYs, low SDI regions now face a heavier burden. Targeted interventions for modifiable risk factors and improved healthcare access in less developed regions are essential to mitigate the global impact of CRC.

背景：
结直肠癌（Colorectal cancer, CRC）是全球范围内主要的癌症相关死亡病因之一。本研究旨在评估1990年至2021年间204个国家和地区的结直肠癌全球疾病负担，并明确其可归因的危险因素。

方法：
结直肠癌的发病率、死亡率及伤残调整生命年（disability-adjusted life years, DALYs）的估算数据来源于2021年全球疾病、伤害和危险因素负担研究（Global Burden of Diseases, Injuries, and Risk Factors Study, GBD），研究在1990-2021年期间按年龄、性别和地理区域进行分层。此外，本研究还计算了与结直肠癌存在明确因果关联的各类危险因素所导致的伤残调整生命年。

结果：
本次估算显示，结直肠癌发病率为每10万人25.36~29.90（95%不确定区间[UI]：25.36~29.90），死亡率为每10万人13.23（95%UI：12.04~14.19），伤残调整生命年率为每10万人309.21（95%UI：287.52~331.52）。全球结直肠癌新发病例数从1990年的916583例增至2021年的2194143例。年龄标化发病率（age-standardized incidence rate, ASIR）从每10万人24.0升至25.6。社会人口学指数（Socio-demographic Index, SDI）较高的地区在2021年的年龄标化发病率最高（每10万人40.5），而SDI较低的地区发病率最低（每10万人7.4）。1990年至2021年间，全球年龄标化死亡率（age-standardized mortality rate, ASDR）从每10万人15.6降至12.4，年龄标化伤残调整生命年率从每10万人357.3降至283.2。但这一降幅在不同SDI地区间分布不均。结直肠癌的主要危险因素包括行为相关及代谢相关因素，其中全谷物饮食摄入不足可显著升高结直肠癌发病风险。

结论：
1990年至2021年，全球结直肠癌疾病负担显著上升，且不同SDI地区间存在显著差异。尽管高SDI地区在降低死亡率和伤残调整生命年方面取得了进展，但低SDI地区目前面临更为沉重的疾病负担。针对可改变的危险因素制定靶向干预措施，并改善欠发达地区的医疗可及性，对于减轻结直肠癌的全球影响至关重要。