Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Rajesh Sharma, Mohsen Abbasi-kangevari, Rami Abd-rabu, Hassan Abidi, Eman Abu-gharbieh, Juan Manuel Acuna, Sangeet Adhikari, Shailesh M Advani, Muhammad Sohail Afzal, Mohamad Aghaie Meybodi, Bright Opoku Ahinkorah, Sajjad Ahmad, Ali Ahmadi, Sepideh Ahmadi, Haroon Ahmed, Luai A Ahmed, Muktar Beshir Ahmed, Hanadi Al Hamad, Fares Alahdab, Fahad Mashhour AlaneziTurki M Alanzi, Fadwa Alhalaiqa Naji Alhalaiqa, Yousef Alimohamadi, Vahid Alipour, Syed Mohamed Aljunid, Motasem Alkhayyat, Sami Almustanyir, Rajaa M Al-raddadi, Saba Alvand, Nelson Alvis-guzman, Saeed Amini, Robert Ancuceanu, Amir Anoushiravani, Ali Arash Anoushirvani, Alireza Ansari-moghaddam, Jalal Arabloo, Armin Aryannejad, Mohammad Asghari Jafarabadi, Seyyed Shamsadin Athari, Floriane Ausloos, Marcel Ausloos, Atalel Fentahun Awedew, Mamaru Ayenew Awoke, Tegegn Mulatu Ayana, Sina Azadnajafabad, Hiva Azami, Mohammadreza Azangou-khyavy, Amirhossein Azari Jafari, Ashish D Badiye, Sara Bagherieh, Saeed Bahadory, Atif Amin Baig, Jennifer L Baker, Maciej Banach, Amadou Barrow, Alemshet Yirga Berhie, Sima Besharat, Devidas S Bhagat, Akshaya Srikanth Bhagavathula, Neeraj Bhala, Krittika Bhattacharyya, Vijayalakshmi S Bhojaraja, Sadia Bibi, Ali Bijani, Antonio Biondi, Tone Bjørge, Belay Boda Abule Bodicha, Dejana Braithwaite, Hermann Brenner, Daniela Calina, Chao Cao, Yin Cao, Giulia Carreras, Felix Carvalho, Ester Cerin, Raja Chandra Chakinala, William C S Cho, Dinh-toi Chu, Joao Conde, Vera Marisa Costa, Natália Cruz-martins, Omid Dadras, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Anna Danielewicz, Feleke Mekonnen Demeke, Getu Debalkie Demissie, Rupak Desai, Deepak Dhamnetiya, Mostafa Dianatinasab, Daniel Diaz, Mojtaba Didehdar, Saeid Doaei, Linh Phuong Doan, Milad Dodangeh, Fatemeh Eghbalian, Debela Debela Ejeta, Michael Ekholuenetale, Temitope Cyrus Ekundayo, Iman El Sayed, Muhammed Elhadi, Daniel Berhanie Enyew, Tahir Eyayu, Rana Ezzeddini, Ildar Ravisovich Fakhradiyev, Umar Farooque, Hossein Farrokhpour, Farshad Farzadfar, Ali Fatehizadeh, Hamed Fattahi, Nima Fattahi, Masood Fereidoonnezhad, Eduarda Fernandes, Getahun Fetensa, Irina Filip, Florian Fischer, Masoud Foroutan, Peter Andras Gaal, Mohamed M Gad, Silvano Gallus, Tushar Garg, Tamiru Getachew, Seyyed-hadi Ghamari, Ahmad Ghashghaee, Nermin Ghith, Maryam Gholamalizadeh, Jamshid Gholizadeh Navashenaq, Abraham Tamirat Gizaw, James C Glasbey, Mahaveer Golechha, Pouya Goleij, Kebebe Bekele Gonfa, Giuseppe Gorini, Avirup Guha, Sapna Gupta, Veer Bala Gupta, Vivek Kumar Gupta, Rasool Haddadi, Nima Hafezi-nejad, Arvin Haj-mirzaian, Rabih Halwani, Shafiul Haque, Sanam Hariri, Ahmed I Hasaballah, Soheil Hassanipour, Simon I Hay, Claudiu Herteliu, Ramesh Holla, Mohammad-salar Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Mowafa Househ, Junjie Huang, Ayesha Humayun, Ivo Iavicoli, Olayinka Stephen Ilesanmi, Irena M Ilic, Milena D Ilic, Farhad Islami, Masao Iwagami, Mohammad Ali Jahani, Mihajlo Jakovljevic, Tahereh Javaheri, Ranil Jayawardena, Rime Jebai, Ravi Prakash Jha, Tamas Joo, Nitin Joseph, Farahnaz Joukar, Jacek Jerzy Jozwiak, Ali Kabir, Rohollah Kalhor, Ashwin Kamath, Neeti Kapoor, Ibraheem M Karaye, Amirali Karimi, Joonas H Kauppila, Asma Kazemi, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Rovshan Khalilov, Javad Khanali, Maryam Khayamzadeh, Mahmoud Khodadost, Hanna Kim, Min Seo Kim, Adnan Kisa, Sezer Kisa, Ali-asghar Kolahi, Hamid Reza Koohestani, Jacek A Kopec, Rajasekaran Koteeswaran, Ai Koyanagi, Yuvaraj Krishnamoorthy, G Anil Kumar, Manoj Kumar, Vivek Kumar, Carlo La Vecchia, Faris Hasan Lami, Iván Landires, Caterina Ledda, Sang-woong Lee, Wei-chen Lee, Yeong Yeh Lee, Elvynna Leong, Bingyu Li, Stephen S Lim, Stany W Lobo, Joana A Loureiro, Raimundas Lunevicius, Farzan Madadizadeh, Ata Mahmoodpoor, Azeem Majeed, Mohammad-reza Malekpour, Reza Malekzadeh, Ahmad Azam Malik, Fariborz Mansour-ghanaei, Lorenzo Giovanni Mantovani, Miquel Martorell, Sahar Masoudi, Prashant Mathur, Jitendra Kumar Meena, Entezar Mehrabi Nasab, Walter Mendoza, Alexios-fotios A Mentis, Tomislav Mestrovic, Junmei Miao Jonasson, Bartosz Miazgowski, Tomasz Miazgowski, Gelana Fekadu Worku Mijena, Seyyedmohammadsadeq Mirmoeeni, Mohammad Mirza-aghazadeh-attari, Hamed Mirzaei, Sanjeev Misra, Karzan Abdulmuhsin Mohammad, Esmaeil Mohammadi, Saeed Mohammadi, Seyyede Momeneh Mohammadi, Abdollah Mohammadian-hafshejani, Shafiu Mohammed, Teroj Abdulrahman Mohammed, Nagabhishek Moka, Ali H Mokdad, Zeinab Mokhtari, Mariam Molokhia, Sara Momtazmanesh, Lorenzo Monasta, Ghobad Moradi, Rahmatollah Moradzadeh, Paula Moraga, Joana Morgado-da-costa, Sumaira Mubarik, Francesk Mulita, Mohsen Naghavi, Mukhammad David Naimzada, Hae Sung Nam, Zuhair S Natto, Biswa Prakash Nayak, Javad Nazari, Ehsan Nazemalhosseini-mojarad, Ionut Negoi, Cuong Tat Nguyen, Son Hoang Nguyen, Nurulamin M Noor, Maryam Noori, Seyyed Mohammad Ali Noori, Virginia Nuñez-samudio, Chimezie Igwegbe Nzoputam, Bogdan Oancea, Oluwakemi Ololade Odukoya, Ayodipupo Sikiru Oguntade, Hassan Okati-aliabad, Andrew T Olagunju, Tinuke O Olagunju, Sokking Ong, Samuel M Ostroff, Alicia Padron-monedero, Reza Pakzad, Adrian Pana, Anamika Pandey, Fatemeh Pashazadeh Kan, Urvish K Patel, Uttam Paudel, Renato B Pereira, Navaraj Perumalsamy, Richard G Pestell, Zahra Zahid Piracha, Richard Charles G Pollok, Akram Pourshams, Naeimeh Pourtaheri, Akila Prashant, Mohammad Rabiee, Navid Rabiee, Amir Radfar, Sima Rafiei, Mosiur Rahman, Amir Masoud Rahmani, Vahid Rahmanian, Nazanin Rajai, Aashish Rajesh, Vajiheh Ramezani-doroh, Kiana Ramezanzadeh, Kamal Ranabhat, Sina Rashedi, Amirfarzan Rashidi, Mahsa Rashidi, Mohammad-mahdi Rashidi, Mandana Rastegar, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Mohammad Sadegh Razeghinia, Andre M N Renzaho, Negar Rezaei, Nima Rezaei, Saeid Rezaei, Mohsen Rezaeian, Sahba Rezazadeh-khadem, Gholamreza Roshandel, Maha Mohamed Saber-ayad, Bahar Saberzadeh-ardestani, Basema Saddik, Hossein Sadeghi, Umar Saeed, Maryam Sahebazzamani, Amirhossein Sahebkar, Amir Salek Farrokhi, Amir Salimi, Hamideh Salimzadeh, Pouria Samadi, Mehrnoosh Samaei, Abdallah M Samy, Juan Sanabria, Milena M Santric-milicevic, Muhammad Arif Nadeem Saqib, Arash Sarveazad, Brijesh Sathian, Maheswar Satpathy, Ione Jayce Ceola Schneider, Mario Šekerija, Sadaf G Sepanlou, Allen Seylani, Feng Sha, Sayed Mohammad Shafiee, Zahra Shaghaghi, Saeed Shahabi, Elaheh Shaker, Maedeh Sharifian, Javad Sharifi-rad, Sara Sheikhbahaei, Jeevan K Shetty, Reza Shirkoohi, Parnian Shobeiri, Sudeep K Siddappa Malleshappa, Diego Augusto Santos Silva, Guilherme Silva Julian, Achintya Dinesh Singh, Jasvinder A Singh, Md Shahjahan Siraj, Gholam Reza Sivandzadeh, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Bogdan Socea, Marco Solmi, Mohammad Sadegh Soltani-zangbar, Suhang Song, Viktória Szerencsés, Miklós Szócska, Rafael Tabarés-seisdedos, Elnaz Tabibian, Majid Taheri, Yasaman Taheriabkenar, Amir Taherkhani, Iman M Talaat, Ker-kan Tan, Abdelghani Tbakhi, Bekele Tesfaye, Amir Tiyuri, Daniel Nigusse Tollosa, Mathilde Touvier, Bach Xuan Tran, Biruk Shalmeno Tusa, Irfan Ullah, Saif Ullah, Marco Vacante, Sahel Valadan Tahbaz, Massimiliano Veroux, Bay Vo, Theo Vos, Cong Wang, Ronny Westerman, Melat Woldemariam, Seyed Hossein Yahyazadeh Jabbari, Lin Yang, Fereshteh Yazdanpanah, Chuanhua Yu, Deniz Yuce, Ismaeel Yunusa, Vesna Zadnik, Mazyar Zahir, Iman Zare, Zhi-jiang Zhang, Mohammad Zoladl

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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 languageEnglish
JournalThe Lancet Gastroenterology & Hepatology
DOIs
Publication statusE-pub ahead of print - 7 Apr 2022

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