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结直肠癌流行病学(1990 - 2050):来自澳大拉西亚地区经验的教训

Colorectal cancer epidemiology (1990-2050): lessons from the Australasian experience.

作者信息

Yao Bihua, Zhang Ying, Li Shikun, Tian Yu, Ashrafizadeh Milad, Rastin Hadi, Tang Min, Li Yan

机构信息

Laboratory Medicine Center, Department of Clinical Laboratory, The First People's Hospital of Jiashan affiliated to Jiaxing University, Jiaxing, Zhejiang, China.

Department of Oncology, Bishan Hospital of Chongqing Medical University, Bishan Hospital of Chongqing, Chongqing, 402760, China.

出版信息

J Transl Med. 2025 Jul 31;23(1):855. doi: 10.1186/s12967-025-06630-z.

Abstract

BACKGROUND

CRC is regarded as a worldwide health issue, exhibiting considerable geographic differences. The current research examines the global epidemiology of CRC (1990-2021) and forecasts trends until 2050, focusing specifically on Australasia.

METHODS

We performed an extensive analysis using data from the Global Burden of Disease 2021 study to calculate age-standardized incidence and mortality rates (ASIR/ASMR) for CRC from 1990 to 2021. Analyses were divided by sex, age, geographic area, and SDI. Temporal trends were evaluated by utilizing EAPC. We assessed the impact linked to significant modifiable risk factors such as dietary risks, elevated body mass index, alcohol consumption, smoking, and lack of physical activity using comparative risk evaluation techniques. To forecast CRC mortality until 2050, we utilized a Bayesian Age-Period-Cohort (BAPC) model that includes demographic and temporal factors.

RESULTS

Regions with high SDI exhibit the highest incidence of CRC but show decreasing trends, whereas regions with middle SDI are experiencing increasing burdens. Australasia, despite its historically high rates, accomplished notable reductions in mortality (-1.95% per year), positioning itself alongside Austria and Germany as frontrunners in CRC management. The rate of CRC occurrence is believed to be greater in males than in females. Dietary elements are the primary alterable risk factor worldwide, particularly in affluent areas. Forecasts and future estimates indicate additional declines in mortality rates in high-income areas, while transitioning economies face rising burdens.

CONCLUSION

The burden of CRC is moving towards developing areas. Australasia showcases effective cancer management via screening and treatment, offering essential insights for global policies and strategies addressing changeable risks.

摘要

背景

结直肠癌被视为一个全球性的健康问题,存在显著的地域差异。当前研究考察了结直肠癌的全球流行病学情况(1990 - 2021年),并预测至2050年的趋势,特别关注澳大拉西亚地区。

方法

我们使用2021年全球疾病负担研究的数据进行了广泛分析,以计算1990年至2021年结直肠癌的年龄标准化发病率和死亡率(ASIR/ASMR)。分析按性别、年龄、地理区域和社会人口指数进行划分。利用EAPC评估时间趋势。我们使用比较风险评估技术评估了与重大可改变风险因素相关的影响,如饮食风险、体重指数升高、饮酒、吸烟和缺乏体育活动。为了预测至2050年的结直肠癌死亡率,我们使用了一个包含人口统计学和时间因素的贝叶斯年龄 - 时期 - 队列(BAPC)模型。

结果

社会人口指数高的地区结直肠癌发病率最高,但呈下降趋势,而社会人口指数中等的地区负担在增加。澳大拉西亚地区尽管历史上发病率较高,但死亡率实现了显著下降(每年 - 1.95%),与奥地利和德国一起成为结直肠癌管理的领先者。结直肠癌的发病率据信男性高于女性。饮食因素是全球主要的可改变风险因素,尤其是在富裕地区。预测和未来估计表明,高收入地区的死亡率将进一步下降,而转型经济体面临的负担将增加。

结论

结直肠癌的负担正在向发展中地区转移。澳大拉西亚地区通过筛查和治疗展示了有效的癌症管理,为应对可改变风险的全球政策和战略提供了重要见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fe9/12312429/f31756991056/12967_2025_6630_Fig1_HTML.jpg

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