Long-term trends in the burden of colorectal cancer in Europe over three decades: a joinpoint regression and age-period-cohort analysis

Dan Long; Chenhan Mao; Zhensheng Zhang; Yaxuan Liu; Jinru Li; Yin Xu; Ying Zhu

doi:10.3389/fonc.2023.1287653

Long-term trends in the burden of colorectal cancer in Europe over three decades: a joinpoint regression and age-period-cohort analysis

Front Oncol. 2023 Dec 5:13:1287653. doi: 10.3389/fonc.2023.1287653. eCollection 2023.

Authors

Dan Long¹, Chenhan Mao², Zhensheng Zhang³, Yaxuan Liu¹, Jinru Li¹, Yin Xu¹, Ying Zhu¹

Affiliations

¹ The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China.
² Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
³ Department of Oncology, The First Traditional Chinese Medicine Hospital of Zhanjiang City, Zhanjiang, Guangdong, China.

Abstract

Background: The burden of colorectal cancer (CRC) in Europe is at a high level, but the epidemiological features have not yet been systematically studied. This study aimed to provide a timely and reliable assessment of the burden and trends of CRC in Europe to provide a scientific basis for its prevention and treatment.

Methods: We analyzed data on CRC in 44 European countries between 1990 and 2019 from the Global Burden of Disease study (GBD) 2019. In addition, the joinpoint regression model was applied to reflect temporal trends. The age-period-cohort model was constructed to explore age, period, and birth cohort effects that influence the risk of morbidity and mortality.

Results: In Europe, new cases, disability-adjusted life years (DALYs) and deaths of CRC rose by 70.01%, 22.88% and 38.04% from 1990 to 2019, respectively. The age-standardized incidence rate (ASIR) has increased, while age-standardized DALY rate and age-standardized mortality rate (ASMR) have declined. We found that men experienced a significantly higher CRC burden than women. Age-period-cohort analysis showed that the risk of incidence and mortality increased with age and time; and it was lower in the later-born cohort than the earlier-born cohort.

Conclusion: ASIR for CRC in Europe generally trended upwards from 1990 to 2019, stabilizing in recent years but still at a high level. CRC burden varied considerably in different countries. There was a pronounced gender difference in CRC burden, and middle-aged and older men should be a priority population for CRC prevention and treatment.

Keywords: Europe; GBD; age-period-cohort analysis; burden of disease; colorectal cancer; joinpoint regression analysis.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by grants from the National Natural Science Foundation of China (81874466 and 82374426) and domestic first-class construction discipline of Chinese Medicine in Hunan University of Chinese Medicine.