TY - JOUR
T1 - National and subnational incidence, mortality and associated factors of colorectal cancer in China
T2 - A systematic analysis and modelling study
AU - Xu, Liying
AU - Zhao, Jianhui
AU - Li, Zihan
AU - Sun, Jing
AU - Lu, Ying
AU - Zhang, Rongqi
AU - Zhu, Yingshuang
AU - Ding, Kefeng
AU - Rudan, Igor
AU - Theodoratou, Evropi
AU - Song, Peige
AU - Li, Xue
AU - Global Health Epidemiology Reference Group (GHERG)
N1 - Funding Information:
Acknowledgements: We appreciate the comprehensive and systematic work by the teams of the Global Burden of Disease Study 2019 and the GLOBOCAN 2020 online database. Ethics statement: The manuscript was not previously published and is not under consideration for publication elsewhere. Funding: XL: Natural Science Fund for Distinguished Young Scholars of Zhejiang Province (LR22H260001), the National Nature Science Foundation of China (82204019); ET: CRUK Career Development Fellowship (C31250/A22804). Authorship contributions: XL, and ET conceptualised the project. LYX performed the data analyses and wrote the first draft. JHZ, JS, YSZ, KFD, PGS, XL, IR, and ET helped with the review and editing. XL revised the final version. All authors critically reviewed the manuscript for important intellectual content. XL is the study guarantor. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and relationships: IR is the Co-Editor in Chief of the of the Journal of Global Health. To ensure that any possible conflict of interest relevant to the journal has been addressed, this article was reviewed according to best practice guidelines of international editorial organisations. Additional material Online Supplementary Document
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/10/13
Y1 - 2023/10/13
N2 - BACKGROUND: Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention.METHODS: We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors.RESULTS: We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC
1 = 5.75, APC
2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies.
CONCLUSIONS: We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies.REGISTRATION: PROSPERO: CRD42022346558.
AB - BACKGROUND: Due to their known variation by geography and economic development, we aimed to evaluate the incidence and mortality of colorectal cancer (CRC) in China over the past decades and identify factors associated with CRC among the Chinese population to provide targeted information on disease prevention.METHODS: We conducted a systemic review and meta-analysis of epidemiolocal studies on the incidence, mortality, and associated factors of CRC among the Chinese population, extracting and synthesising data from eligible studies retrieved from seven global and Chinese databases. We pooled age-standardised incidence rates (ASIRs) and mortality rates (ASMRs) for each province, subregion, and the whole of China, and applied a joinpoint regression model and annual per cent changes (APCs) to estimate the trends of CRC incidence and mortality. We conducted random-effects meta-analyses to assess the effect estimates of identified associated risk factors.RESULTS: We included 493 articles; 271 provided data on CRC incidence or mortality, and 222 on associated risk factors. Overall, the ASIR of CRC in China increased from 2.75 to 19.39 (per 100 000 person-years) between 1972 and 2019 with a slowed-down growth rate (APC
1 = 5.75, APC
2 = 0.42), while the ASMR of CRC decreased from 12.00 to 7.95 (per 100 000 person-years) between 1974 and 2020 with a slight downward trend (APC = -0.89). We analysed 62 risk factors with synthesized data; 16 belonging to the categories of anthropometrics factors, lifestyle factors, dietary factors, personal histories and mental health conditions were graded to be associated with CRC risk among the Chinese population in the meta-analysis limited to the high-quality studies.
CONCLUSIONS: We found substantial variation of CRC burden across regions and provinces of China and identified several associated risk factors for CRC, which could help to guide the formulation of targeted disease prevention and control strategies.REGISTRATION: PROSPERO: CRD42022346558.
U2 - 10.7189/jogh.13.04096
DO - 10.7189/jogh.13.04096
M3 - Article
C2 - 37824177
SN - 2047-2978
VL - 13
JO - Journal of Global Health
JF - Journal of Global Health
M1 - 04096
ER -