结直肠癌的演变景观：全球和区域负担、风险因素动态和未来情景（1990-2050年全球疾病负担）。

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-02-01 DOI:10.1016/j.arr.2025.102666

Jiajie Zhou , Qizhi Yang , Shuai Zhao , Longhe Sun , Ruiqi Li , Jie Wang , Liuhua Wang , Daorong Wang

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引用次数: 0

摘要

背景：目前，结直肠癌（CRC）是全球癌症相关死亡的第二大原因。我们提供了1990年至2021年全球、地区和国家的结直肠癌负担及其归因风险估计，旨在指导筛查、早期发现和治疗策略，优化医疗资源配置，促进结直肠癌负担的合理管理。方法：使用来自全球疾病负担数据库的数据，我们估计了CRC的发病率、死亡率和残疾调整生命年（DALYs）。通过计算估计的年百分比变化（EAPC）来量化结直肠癌年龄标准化率的时间趋势。对有证据表明与结直肠癌有因果关系的每个危险因素所导致的结直肠癌死亡进行估计。以社会人口指数作为预测因子，通过逻辑回归预测到2050年的CRC死亡和伤残调整年，然后乘以预计的人口估计值。结果：在全球范围内，1990 - 2021年间，CRC的发病例数、死亡例数和DALYs均翻了一番，年龄标准化发病率（ASIR）呈轻微上升趋势，而年龄标准化死亡率（ASMR）和年龄标准化DALYs率（ASDR）呈下降趋势。从1990年到2021年，男性的ASIR呈上升趋势，而女性呈下降趋势。社会人口指数（SDI）高、中高的国家CRC的ASIR和ASDR较高。165个国家和地区的CRC发病率呈上升趋势。在全球范围内，对于男性和两性而言，全谷物饮食不足是2021年结直肠癌年龄标准化死亡的主要风险因素。然而，在女性中，低奶饮食是主要的危险因素。我们预测，到2050年，全球将有218万（1.53-2.94）人死于结直肠癌，到2050年，DALYs将达到4170万（29.9-55.4）。结论：在大多数国家，CRC的发病率和死亡率翻了一番，ASIR也在上升，这表明CRC带来了沉重的负担。当局应该制定适当的措施来解决日益增加的负担，例如优化筛查计划，提高对男性的认识和筛查工作，以及减少暴露于可改变的风险因素。

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Evolving landscape of colorectal cancer: Global and regional burden, risk factor dynamics, and future scenarios (the Global Burden of Disease 1990–2050)

Background

Presently, colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. We provided global, regional, and national estimates of the burden of CRC and their attributable risks from 1990 to 2021, aiming to guide screening, early detection, and treatment strategies, optimize healthcare resource allocation, and facilitate the rational management of burden of CRC.

Methods

Using data derived from the Global Burden of Disease database, we estimated the incidence, mortality, and disability-adjusted life years (DALYs) of CRC. The temporal trends of the age-standardized rate of CRC were quantified by calculating the estimated annual percentage changes (EAPC). Deaths from CRC attributable to each risk factor that had evidence of causation with CRC were estimated. CRC's deaths and DALYs was forecast through 2050 by logistic regression with Socio-Demographic Index as a predictor, then multiplying by projected population estimates.

Results

Globally, between 1990 and 2021, the incident cases, death cases, and DALYs attributed to CRC have doubled, the age-standardized incidence rate (ASIR) presented a slightly upward tendency, while the age-standardized death rate (ASMR) and the age-standardized DALYs rate (ASDR) exhibited a decreasing trend. From 1990–2021, the ASIR for males has an increased trend, while females presented a downward trend. The ASIR and ASDR of CRC were higher in high and high-middle sociodemographic index (SDI) countries. The ASIR of CRC in 165 countries and territories showed escalating trend. Globally, for males and both sexes combined, diet low in whole grains was the leading risk factor for age-standardized deaths from CRC in 2021. However, among females, diet low in milk was the leading risk factor. We forecast that 2.18 million (1.53–2.94) individuals will death for CRC worldwide by 2050, and the DALYs achieve 41.7 million (29.9–55.4) by 2050.

Conclusion

The doubling of incidence counts and mortality cases and the rising ASIR in most countries indicates a significant burden of CRC. Authorities should devise suitable measures to address the increasing burdens, such as optimizing screening programs, enhancing awareness and screening efforts for males, and reducing exposure to modifiable risk factors.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.