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The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017

The Lancet: Gastroenterology & Hepatology Nov 02, 2019

Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used in order to give a status report on the incidence, mortality, and disability caused due to colorectal cancer in 195 countries and territories between 1990 and 2017. In 2017, 1·8 million incident cases of colorectal cancer worldwide were there, with an age-standardized incidence rate of 23·2 per 100,000 person-years that rose by 9·5% between 1990 and 2017. Worldwide, colorectal cancer was responsible for 896,000 deaths in 2017, with an age-standardized death rate of 11·5 per 100,000 person-years, which reduced between 1990 and 2017. Colorectal cancer was also accountable for 19·0 million DALYs worldwide in 2017, with an age-standardized rate of 235·7 DALYs per 100,000 person-years, which reduced between 1990 and 2017. Among males vs females up to the ages of 80–84 years, numbers of incident cases and deaths were greater, with the highest rates noted in the elderly age group (≥ 95 years) for both genders in 2017. A non-linear relationship between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardized DALY rates was noted. In 2017, for both genders, at the global level, the three biggest contributors to DALYs were diet low in calcium, alcohol use, and diet low in milk. Substantial global difference in the burden of colorectal cancer was seen. However, the overall colorectal cancer age-standardized death rate has been reducing at the global level, the increasing age-standardized incidence rate in most countries acts a chief public health challenge all over the world. Hence, the results of this study could be beneficial for policy makers to conduct cost-efficient interventions and to decrease exposure to modifiable risk factors, especially in countries with high incidence or rising burden.
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