Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 627-647 |
| Number of pages | 21 |
| Journal | The Lancet Gastroenterology and Hepatology |
| Volume | 7 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 07-2022 |
All Science Journal Classification (ASJC) codes
- Hepatology
- Gastroenterology
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In: The Lancet Gastroenterology and Hepatology, Vol. 7, No. 7, 07.2022, p. 627-647.
Research output: Contribution to journal › Article › peer-review
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 - Holla, Ramesh
AU - Joseph, Nitin
AU - Kamath, Ashwin
N1 - Funding Information: R Ancuceanu reports consulting fees from AbbVie; payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from AbbVie, Sandoz, and B Braun; all outside the submitted work. M Ausloos reports grants from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084 “Understanding and modelling time-space patterns of psychology-related inequalities and polarization” (October, 2018, to September, 2022), outside the submitted work. J Conde reports grants from the European Research Council Starting Grant (ERC-StG-2019-848325); patents planned, issued or pending for functionalised nanoparticles and compositions for cancer treatment and methods (US Application No. 62/334538), and TRPV2 Antagonists WO Application No. PCT/PT2018/050035; all outside the submitted work. I Fillip reports consulting fees from Avicenna Medical and Clinical Research Institute, outside the submitted work. N Ghith reports grants from Novo Nordisk Foundation as salary payment (NNF16OC0021856), outside the submitted work. A Guha reports grants from the American Heart Association as the Strategically Focused Research Network Grant in Disparities in Cardio-Oncology (#847740 and #863620), outside the submitted work. C Herteliu and A Pana report grants or contracts from Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084 (October, 2018, to September, 2022) “Understanding and modelling time-space patterns of psychology-related inequalities and polarization” and Project number PN-III-P2-2·1-SOL-2020-2-0351 (June to October, 2020) “Approaches within public health management in the context of COVID-19 pandemic”, all outside the submitted work. C Herteliu reports grants from the Ministry of Labour and Social Justice, Romania, project number 30/PSCD/2018, “Agenda for skills Romania 2020–2025;” outside the submitted work. J Jozwiak reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from Teva, Amgen, Synexus, Boehringer Ingelheim, Alab Laboratories, and Zentiva as personal fees, all outside the submitted work. J H Kauppila reports grants from the Sigrid Juselius Foundation and Finnish Cancer Foundation as research grants paid to their institutions; all outside the submitted work. J A Loureiro reports support for the present manuscript from Fundação para a Ciência e Técnologia (FCT) as a salary payment under the Scientific Employment Stimulus (CEECINST/00049/2018) and from FCT/MCTES (Ministério da Ciência, Tecnologia e Ensino Superior) (PIDDAC) as Base Funding (UIDB/00511/2020 of LEPABE). A-F A Mentis reports grants or contracts from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860) and EPANEK - MilkSafe (Τ2ΕΔΚ-02222), all outside the submitted manuscript. O O Odukoya reports support for the present manuscript from the Fogarty International Center of the National Institutes of Health under the award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. A Radfar reports consulting fees from Avicenna Medical and Clinical Research Institute; leadership or fiduciary role in other board, society, committee, or advocacy group, paid or unpaid with MEDICHEM as a board member; all outside the submitted work. M Šekerija reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from Roche and Johnson & Johnson, outside the submitted work. D A S Silva reports support for the present manuscript in part from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil (CNPq - 302028/2018-8), as payments made to their institution. J A Singh reports consulting fees from Crealta/Horizon, Medisys, Fidia, Two labs, Adept Field Solutions, Clinical Care Options, ClearView Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, UBM, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Simply Speaking; support for attending meetings or travel, or both from OMERACT, an international organisation that develops measures for clinical trials and receives arm's length funding from 12 pharmaceutical companies, when traveling to OMERACT meetings; participation on a data safety monitoring board or advisory board as a member of the FDA Arthritis Advisory Committee; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with OMERACT as a member of the steering committee, with the Veterans Affairs Rheumatology Field Advisory Committee as a member, and with the UAB Cochrane Musculoskeletal Group Satellite Center on Network Meta-analysis as a director and editor; stock or stock options in TPT Global Tech, Vaxart Pharmaceuticals and Charlotte's Web Holdings, and previously owned stock options in Amarin, Viking, and Moderna Pharmaceuticals; all outside the submitted work. M Solmi reports payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events from Lundbeck; and participation on a data safety monitoring board or advisory board with Angelini; all outside the submitted work. T Vos reports support for the present manuscript from the Bill & Melinda Gates Foundation as payment to their institution. All other authors declare no competing interests. Funding Information: This research was supported by funding from the Bill & Melinda Gates Foundation. J M Acuna acknowledges support from the Khalifa University College of Medicine and Health Sciences, Research and Data Intelligence Support Center, Khalifa University, Abu Dhabi, United Arab Emirates. S Ahmad thanks the Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan, for their support. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait, for approval and support to participate in this research project. F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. N Ghith acknowledges support by a grant from Novo Nordisk Foundation (NNF16OC0021856) in the form of salary payments. J C Glasbey is supported by a National Institute of Health Research (NIHR) Academy Doctoral Research Fellow (NIHR300175). V K Gupta and V B Gupta acknowledge funding support from the National Health and Medical Research Council (NHMRC), Australia. S Haque acknowledges support from the Jazan University, Jazan, Saudi Arabia, for providing the access of the Saudi Digital Library for this research study. A Pana, M Ausloos, and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. M Jakovljevic acknowledges support from the Ministry of Education Science and Technological Development of the Republic of Serbia through the Grant OI175014 and from the Science Fund of The Republic of Serbia through Grant Em-CEAS. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama's Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). B Li was supported by the Guangdong Philosophy and Social Science Fund (GD21YSH06), the Shenzhen Philosophy and Social Science Fund (grant number SZ2020C015), and the Shenzhen Science and Technology Fund (grant number 20200805164059001). J A Loureiro was supported by national funds through the Fundação para a Ciência e Tecnologia, under the Scientific Employment Stimulus (CEECINST/00049/2018). V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama's Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya acknowledges support from the Fogarty International Center of the National Institutes of Health under the award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the US National Institutes of Health. A M Samy acknowledges the support from the Egyptian Fulbright Mission Program. D A S Silva acknowledges support in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil (CNPq - 302028/2018-8). Funding Information: This research was supported by funding from the Bill & Melinda Gates Foundation. J M Acuna acknowledges support from the Khalifa University College of Medicine and Health Sciences, Research and Data Intelligence Support Center, Khalifa University, Abu Dhabi, United Arab Emirates. S Ahmad thanks the Department of Health and Biological Sciences, Abasyn University, Peshawar, Pakistan, for their support. S M Aljunid acknowledges the Department of Health Policy and Management, Faculty of Public Health, Kuwait University, Kuwait, for approval and support to participate in this research project. F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. N Ghith acknowledges support by a grant from Novo Nordisk Foundation (NNF16OC0021856) in the form of salary payments. J C Glasbey is supported by a National Institute of Health Research (NIHR) Academy Doctoral Research Fellow (NIHR300175). V K Gupta and V B Gupta acknowledge funding support from the National Health and Medical Research Council (NHMRC), Australia. S Haque acknowledges support from the Jazan University, Jazan, Saudi Arabia, for providing the access of the Saudi Digital Library for this research study. A Pana, M Ausloos, and C Herteliu are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. M Jakovljevic acknowledges support from the Ministry of Education Science and Technological Development of the Republic of Serbia through the Grant OI175014 and from the Science Fund of The Republic of Serbia through Grant Em-CEAS. I Landires is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama's Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). B Li was supported by the Guangdong Philosophy and Social Science Fund (GD21YSH06), the Shenzhen Philosophy and Social Science Fund (grant number SZ2020C015), and the Shenzhen Science and Technology Fund (grant number 20200805164059001). J A Loureiro was supported by national funds through the Fundação para a Ciência e Tecnologia, under the Scientific Employment Stimulus (CEECINST/00049/2018). V Nuñez-Samudio is a member of the Sistema Nacional de Investigación (SNI), which is supported by Panama's Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT). O O Odukoya acknowledges support from the Fogarty International Center of the National Institutes of Health under the award number K43TW010704. The content is solely the responsibility of the authors and does not necessarily represent the official views of the US National Institutes of Health. A M Samy acknowledges the support from the Egyptian Fulbright Mission Program. D A S Silva acknowledges support in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brazil (CAPES)—Finance Code 001 and in part by Conselho Nacional de Desenvolvimento Científico e Tecnológico, Brazil (CNPq - 302028/2018-8). Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published maps and institutional affiliations. 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.
UR - http://www.scopus.com/inward/record.url?scp=85128844137&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85128844137&partnerID=8YFLogxK
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 -