National and subnational incidence, mortality and associated factors of colorectal cancer in China: A systematic analysis and modelling study

Abstract

Background Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention. Methods We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors. Results We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC 1 = 5.75, APC 2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies. Conclusions We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies. Registration PROSPERO: CRD42022346558.

Gut microbiota characteristics of colorectal cancer patients in Hubei, China, and differences with cohorts from other Chinese regions

“…China is the most populous country in the world and also one of the countries with a high incidence of CRC ( Shao et al, 2023 ). In China, CRC incidence and mortality vary widely among regions and provinces ( Zhang et al, 2019 ; Xu et al, 2023 ). China’s diverse geographical environment, with its abundant habitats, influences unique eating habits that not only shape the gut microbiota with regional characteristics but also play a significant role in the varying incidence of CRC across different regions ( Zhang et al, 2019 ; Lin et al, 2020 ; Yang et al, 2020 ; Wang et al, 2023 ; Xu et al, 2023 ).…”

“…In China, CRC incidence and mortality vary widely among regions and provinces ( Zhang et al, 2019 ; Xu et al, 2023 ). China’s diverse geographical environment, with its abundant habitats, influences unique eating habits that not only shape the gut microbiota with regional characteristics but also play a significant role in the varying incidence of CRC across different regions ( Zhang et al, 2019 ; Lin et al, 2020 ; Yang et al, 2020 ; Wang et al, 2023 ; Xu et al, 2023 ). While there have been reports on the gut microbiota (GM) characteristics of CRC patients in various regions, there is currently no large-scale study focusing on the differences in GM among CRC patients in different regions of China ( Jin et al, 2019 ; Yang et al, 2021 ; Yi et al, 2021 ; Li et al, 2022 ; Feng et al, 2023 ; Wang et al, 2023 ).…”

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“…China is the most populous country in the world and also one of the countries with a high incidence of CRC (Shao et al, 2023). In China, CRC incidence and mortality vary widely among regions and provinces (Zhang et al, 2019;Xu et al, 2023). China's diverse geographical environment, with its abundant habitats, influences unique eating habits that not only shape the gut microbiota with regional characteristics but also play a significant role in the varying incidence of CRC across different regions (Zhang et al, 2019;Lin et al, 2020;Yang et al, 2020;Xu et al, 2023).…”

“…In China, CRC incidence and mortality vary widely among regions and provinces (Zhang et al, 2019;Xu et al, 2023). China's diverse geographical environment, with its abundant habitats, influences unique eating habits that not only shape the gut microbiota with regional characteristics but also play a significant role in the varying incidence of CRC across different regions (Zhang et al, 2019;Lin et al, 2020;Yang et al, 2020;Xu et al, 2023). While there have been reports on the gut microbiota (GM) characteristics of CRC patients in various regions, there is currently no large-scale study focusing on the differences in GM among CRC patients in different regions of China (Jin et al, 2019;Yang et al, 2021;Yi et al, 2021;Li et al, 2022;Feng et al, 2023;.…”