肿瘤预防与治疗2025，Vol.38Issue(11)：970-979,10.DOI:10.3969/j.issn.1674-0904.2025.11.004
基于GBD数据库的中国与全球早发性结直肠癌疾病负担对比分析
Comparative Analysis of the Early-Onset Colorectal Cancer Burden in China and Globally:Based on Data from the GBD Database
摘要
Abstract
Objective:This study aims to compare the disease burden of early-onset colorectal cancer(EO-CRC)in Chi-na with global levels,utilizing data from the Global Burden of Disease(GBD)2021 study.Our objectives are to assess long-term trends,investigate underlying drivers,and provide insights for evaluating current prevention efforts and refining CRC strategies for young populations in China.Methods:Data on the disease burden of colorectal cancer in individuals aged 15～49 years in China and globally from 1990 to 2021 were obtained from the GBD study.All burden estimates were age-standardized to ensure comparability across populations and over time.Joinpoint regression analysis was employed to assess temporal trends in disease burden,using the annual percentage change and average annual percentage change(AAPC)to quantify the rate and direction of changes.Decomposition analysis was performed to identify the primary drivers underlying changes in the disease burden.Additionally,Spearman correlation analysis was conducted to examine the association between disease burden and the Socio-demographic Index(SDI).Future trends in disease burden from 2022 to 2050 were estimated using the Bayesian Age-Period-Cohort(BAPC)model.Results:From 1990 to 2021,China experienced a dramatic 56.22％rise in the age-standardized incidence rate(ASIR)of EO-CRC,far exceeding the global modest increase of 12.45％.During the same period,China's age-standardized mortality rate(ASMR)and age-standardized disability-adjusted life years(DA-LYs)rate(ASDR)of EO-CRC in China declined by 25.00％and 23.41％,respectively.These reductions slightly excee-ded the corresponding global declines of 23.41％and 22.87％.Age-stratified analysis revealed that the highest disease bur-den was in the 45～49 age group.Across all age groups,the incidence,mortality,and DALYs rates in China consistently exceeded the global levels.Gender-stratified analysis demonstrated a higher disease burden in men than in women.The ASIR in Chinese men rose by 89.66％,compared to only 9.54％in women.Declines in ASMR and ASDR were more pronounced in women than in men,both in China and globally.Joinpoint regression analysis demonstrated that from 1990 to 2021,the ASIR of EO-CRC exhibited a significant upward trend both in China and globally.The AAPC was 1.48％(95％CI:1.17％～1.80％,P＜0.001)in China and 0.37％(95％CI:0.24％～0.37％,P＜0.001)globally.Over the same period,both the ASMR and ASDR for EO-CRC declined in China and worldwide.In China,the AAPC for ASMR was-0.90％(95％CI:-1.29％～-0.51％,P＜0.001),and for ASDR it was-0.84％(95％CI:-1.02％～-0.67％,P＜0.001).Comparable global AAPCs were-0.84％(95％CI:-1.23％～-0.45％,P＜0.001)for ASMR and-0.83％(95％CI:-1.03％～-0.63％,P＜0.001)for ASDR.Decomposition analysis revealed that the changes in dis-ease burden in China were mainly driven by shifts in age structure,whereas global changes were predominantly attributed to population growth.Spearman correlation analysis revealed a strong positive association between China's ASIR and the SDI(r=0.91,P＜0.001).Projections using the BAPC model estimated that from 2022 to 2050,the ASIR of EO-CRC in China will decline by 10.49％,notably less than the projected global decrease of 22.11％;and that China's ASMR and AS-DR are expected to decrease by 53.92％and 54.97％,respectively,exceeding the global reductions of 44.27％and 45.41％.Notably,the predicted declines in ASIR,ASMR,and ASDR are greater in Chinese women than in men.Conclu-sion:Over the past 30 years,while the incidence of EO-CRC has climbed in both China and globally,mortality and DALYs have fallen significantly,with notable variations by sex and age group.The overall disease burden in China is higher than the global level during the same period.Although projections indicate a downward trend over the next 30 years,China's EO-CRC burden is projected to remain substantial.It is urgent to strengthen health education,enhance preventive measures,continuously promote early screening,diagnosis,and treatment.Particular attention should be directed toward high-risk young males to further improve the overall effectiveness of EO-CRC control.关键词
结直肠癌/年轻人群/全球疾病负担/中国/社会人口学指数Key words
Colorectal cancer/Young population/Global burden of disease/China/Socio-demographic index分类
医药卫生引用本文复制引用
沈才路,吴锐荣..基于GBD数据库的中国与全球早发性结直肠癌疾病负担对比分析[J].肿瘤预防与治疗,2025,38(11):970-979,10.基金项目
无锡市卫生健康委员会科研课题(编号:Q202201) This study was supported grants from Wuxi Municipal Health Commission(No.Q202201). （编号:Q202201）
