Global, regional, and national burden of colorectal cancer, 19902021: An analysis from global burden of disease study 2021.

Objective: Data on the global, regional and national changes in the trends of colorectal cancer (CRC) are analyzed to understand the trends in its burden, in order to assist policymakers in allocating healthcare resources and developing prevention and control strategies.

Methods: This study analyzed trends in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and disability-adjusted life years (DALYs) for CRC from 1990 to 2021 using data from the Global Burden of Disease (GBD) 2021 database. The trends of burden and effectiveness of control strategies were assessed using jointpoint regression analysis, decomposition analysis and frontier analysis.

Results: Globally, the ASMR and age-standardized DALYs for CRC have shown a declining trend, but the ASIR was still increasing. The number of new cases of CRC in 2021 was higher in males than in females, the values were 1,263.46 thousands [95% confidence interval (95% CI): 1,146.50, 1,400.38] . 930.68 thousands (95% CI: 824.67, 1,017.65). The change in DALYs was mainly due to population growth (111.42%). The high socio-demographic index (SDI) region had an ASIR of 40.52 (95% CI: 37.45, 42.45), and the low SDI region had an ASIR of 7.39 (95% CI: 6.65, 8.19). The ASIR for CRC showed an upward trend in all SDI regions before age of 40 years. Among the four world regions, only America showed a downward trend in ASIR, with an estimated annual percentage change (EAPC) of -0.62 (95% CI: -0.71, -0.53). Among the 204 countries and territories, Netherlands, Monaco, and Bermuda were the top 3 countries with the highest ASIR in 2021. In the frontier analysis of DALYs, the 10 countries with the longest effective distances all had SDI levels above 0.70.

Conclusions: Although ASMR and age-standardized DALYs are declining, ASIR is still increasing globally and in many regions. The burden of CRC varies significantly across the globe, and more targeted screening strategies and prevention measures are needed to address the problem of CRC.