Burden of early-onset colorectal cancer along with attributable risk factors from 1990 to 2019: a comparative study between China and other G20 countries

Abstract

Purpose The credible data about the burden of early-onset colorectal cancer (EOCRC) in China when compared to other countries in the group of twenty (G20) remained unavailable. We aimed to assess the burden and trends of EOCRC and attributable risk factors in China. Meanwhile, the comparison in the burden and attributable risk factors between China and other G20 countries was also evaluated. Methods Data on the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and attributable risk factors of EOCRC in China were obtained from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 and compared with other G20countries. Temporal trends of age-standardized rates for incidence, prevalence, mortality, and DALYs were evaluated by estimated annual percentage change (EAPC). The autoregressive integrated moving average (ARIMA) model was used to forecast the incidence, mortality, and DALY rates of EOCRC in China from 2020 to 2029. Results From 1990 to 2019, the age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) of EOCRC in China increased with the EAPCs of 4.61 [95% confidence interval (CI): 4.45–4.77] and 5.82 (95% CI: 5.60–6.05). When compared to G20 countries, China was ranked 13th in the ASIR in 1990 and then increased to 2nd in 2019, second only to Japan. The ASPRs increased in all G20 countries, being highest in Saudi Arabia, followed by China and Mexico. Moreover, China had the highest age-standardized mortality rate and highest age-standardized DALY rate in 2019. In China, the five leading risk factors, for both sexes, were diet low in milk [18.54% (95% UI: 12.71–24.07)], diet low in calcium [15.06% (95% UI: 10.70–20.03)], alcohol use [12.16% (95% UI: 8.87–15.64)], smoking [9.08% (95% UI: 3.39–14.11)], and diet high in red meat [9.08% (95% UI: 3.39–14.11)] in 2019. Over the next 10 years, ASIR, ASMR, and age-standardized DALY rate of EOCRC will increase continuously in males and females. Conclusion The burden of EOCRC in China and other G20 countries is worrisome, indicating that coordinated efforts are needed to conduct high-quality researches, allocate medical resources, adjust screening guidelines, and develop effective treatment and prevention strategies in the G20 countries.

Prediction of early‐onset colorectal cancer mortality rates in the United States using machine learning

“…However, it is important to note that risk factors for early‐onset CRC have been well‐studied, including increasing age, higher BMI or obesity, and family history of cancer. 13 Our study aligns with these findings, extends them by providing predictive models for future trends, and underscores the urgent need for interventions targeting these modifiable risk factors, as highlighted in existing literature.…”

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

“…Several American guidelines, including the American Cancer Society (ACS) [25], National Comprehensive Cancer Network (NCCN) [26], American College of Gastroenterology (ACG) [27] and the US preventative task force now recommend starting screening of average risk individuals at 45 years of age [28,29]. While there is no direct evidence that screening below the age of 50 years will reduce EOCRC, countries such as Italy, Austria and Japan have been screening patients in their 40's since the 1980s [24], and they are some of the few countries internationally where EOCRC rates have been declining [3,17,30,31].…”

Early-onset gastrointestinal cancer: An epidemiological reality with great significance and implications

“…Li et al [ 28 ] studied the epidemiologic and clinical parameters and risk factors of Chinese patients with early-CRC and compared the results with counterparts from the G20 countries. The results showed that between 1990 and 2019, the age-standardized incidence rate and age-standardized prevalence rate of early-CRC in China increased (estimated annual percentage change 4.61 and 5.82).…”

“…The main risk factors for both sexes in Chinese patients in 2019 were a diet low in milk and calcium, drinking alcohol, smoking, and a diet high in red meat. It is estimated that during the next 10 years the age-standardized incidence rate, the age-standardized mortality rate, and the age-standardized rate of disability-adjusted life years will continuously increase in both sexes[ 28 ].…”