Abstract
Purpose
To explore the disease burden of early-onset colorectal cancer (EO-CRC) in individuals aged 40–49 years and provide baseline evidence for routine recommended age adjustment for CRC screening and other clinical decision-making.
Methods
We collected data stratified by sex, risk factors, and socio-demographic index (SDI) from the Global Burden of Disease Study 2019 Data Resources. Trends in disease burden were analyzed by estimated annual percentage change. The Bayesian age-period-cohort model predicted the burden over the following 10 years.
Results
In 2019, the global rates of incidence, mortality, prevalence, and disability-adjusted life year (DALY) of EO-CRC in people aged 40–44 years were 11.48 (95% uncertainty interval: 10.50–12.59), 4.35 (4.01–4.70), 72.63 (66.48–79.52), 209.82 (193.55–226.59) per 100,000 population. For people aged 45–49 years, the rates of these four estimates were 19.63 (17.97–21.54), 7.76 (7.16–8.41), 121.73 (110.99–133.84), and 335.83 (310.14–362.91), respectively. The incidence and prevalence rates for both age groups increased while the mortality and DALY rates remained stable from 1990 to 2019. In 2019, high-income North America had the highest incidence and prevalence rates. A low milk diet accounted for the largest proportion of global DALYs in EO-CRC, and there was a tendency for the DALY rate first to increase and then decrease with increasing SDI. The incidence and mortality rates were predicted to increase in the next 10 years.
Conclusion
The current and future burden of EO-CRC among people aged 40–49 years is heavy. Substantial variation exists in disease burden across regions and countries. Urgent screening actions and policies are needed.
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Data availability
The datasets analysed during the current study are available at the https://ghdx.healthdata.org/.
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Study conception and design: XT and JP. Drafting of manuscript, formal analysis, and visualization: XT, JP, SH, HX. Acquisition of data and resources: PW, JJ, WZ, XS, LS, XZ. Revision of manuscript, and final approval of manuscript: ML, XT. All authors read and approved the final manuscript.
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Supplementary Fig. 1
The global mortality rate of early-onset colorectal cancer among people aged 40–44 and 45–49 years in 204 countries and territories. (A The mortality rate of early-onset colorectal cancer among people aged 40–44 years in 2019; B The EAPC of the mortality rate of early-onset colorectal cancer among people aged 40–44 years from 1990 to 2019; C The mortality rate of early-onset colorectal cancer among people aged 45–49 years in 2019; D The EAPC of the mortality rate of early-onset colorectal cancer among people aged 45–49 years from 1990 to 2019.) EAPC estimated annual percentage change (JPG 528 KB)
Supplementary Fig. 2
Proportion of DALYs of early-onset colorectal cancer among people aged 40–44 and 45–49 years attributable to smoking, alcohol use, high BMI, and diets low in calcium, whole grains, and milk for 21 GBD regions in 1990. A 40–44 years old; B 45–49 years old. GBD Global Burden of Diseases, Injuries, and Risk Factors Study, DALYs Disability-Adjusted Life Years, BMI body mass index (JPG 705 KB)
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Tang, X., Peng, J., Huang, S. et al. Global burden of early-onset colorectal cancer among people aged 40–49 years from 1990 to 2019 and predictions to 2030. J Cancer Res Clin Oncol 149, 16537–16550 (2023). https://doi.org/10.1007/s00432-023-05395-6
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DOI: https://doi.org/10.1007/s00432-023-05395-6