Colorectal cancer burden, trends and risk factors in China: A review and comparison with the United States

Qianru Li; Hongliang Wu; Maomao Cao; He Li; Siyi He; Fan Yang; Xinxin Yan; Shaoli Zhang; Yi Teng; Changfa Xia; Ji Peng; Wanqing Chen

doi:10.21147/j.issn.1000-9604.2022.05.08

Colorectal cancer burden, trends and risk factors in China: A review and comparison with the United States

Chin J Cancer Res. 2022 Oct 30;34(5):483-495. doi: 10.21147/j.issn.1000-9604.2022.05.08.

Authors

Qianru Li¹, Hongliang Wu², Maomao Cao¹, He Li¹, Siyi He¹, Fan Yang¹, Xinxin Yan¹, Shaoli Zhang¹, Yi Teng¹, Changfa Xia¹, Ji Peng³, Wanqing Chen¹

Affiliations

¹ Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College/Chinese Academy of Medical Sciences Key Laboratory for National Cancer Big Data Analysis and Implement, Beijing 100021, China.
² Department of Anesthesiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
³ Department of Cancer Prevention and Control, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.

PMID: 36398126
PMCID: PMC9646460
DOI: 10.21147/j.issn.1000-9604.2022.05.08

Abstract

Objective: China and the United States (the U.S.) have the heaviest colorectal cancer (CRC) burden with considerable variations in temporal trends. This study aims to analyze the temporal patterns of CRC burden and its risk factors in China and the U.S. across the past three decades.

Methods: Data were extracted from the Global Burden of Disease (GBD) Study in 2019, including cases, deaths, disability-adjusted life-years (DALYs), age-standardized rate (ASR), and summary exposure value (SEV) of CRC in China and the U.S. between 1990 and 2019. Annual average percentage changes (AAPCs) of CRC burden were calculated using the Joinpoint regression model. The mortality in CRC attributable to potential risk factors was characterized by countries, gender, and age groups.

Results: In 2019, there were 607,900 and 227,241 CRC cases, and 261,777 and 84,026 CRC deaths in China and the U.S., respectively. The age-standardized incidence rate (ASIR) was 30.55 per 100,000 in China and 41.86 per 100,000 in the U.S., and the age-standardized mortality rate (ASMR) was 13.86 per 100,000 in China and 14.77 per 100,000 in the U.S. CRC incidence, mortality, and DALY rate in the U.S. showed downward trends in the past three decades (AAPC=-0.47, -1.06, and -0.88, respectively), while upward trends were observed in China (AAPC=3.11, 1.05, and 0.91, respectively). Among the cause of CRC, the leading risk factor contributing to CRC death was low milk in China and smoking in the U.S., respectively.

Conclusions: From 1990 to 2019, the burden of CRC in China increased dramatically, particularly for males and middle-aged and elderly people. The management of the major risk factors associated with the high burden of CRC should be enhanced.

Keywords: China; Colorectal cancer; burden; the U.S.; trends.