Burden of colorectal cancer in China, 1990 − 2017: Findings from the Global Burden of Disease Study 2017

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Abstract

Objective

Our goal is to analyze the trend of colorectal cancer (CRC) regarding the death, incidence and prevalence rates over time, and to provide epidemiological knowledge basis for health policy revision by comparing data about fatal outcomes of CRC in 2017 to those data in 1990, which was extracted from the Global Burden of Disease (GBD).

Methods

The time trend and changes of CRC burden from 1990 to 2017 were measured by using the methods and results from the Institute for Health Metrics and Evaluation (IHME) GBD 2017, based on the rates of death, incidence and prevalence.

Results

The death rate of CRC is 13.24/100,000, accounting for 1.79% of total deaths in China in 2017. In 1990, CRC ranked 21st in all causes of death in China compared to its 11th ranking in 2017. The death, incidence and prevalence rate of CRC were standardized by the age scale of the global population in 2010, the change of standardized death rate of CRC was not significant, from 9.33/100,000 in 1990 to 10.10/100,000 in 2017. The standardized incidence rate of CRC significantly increased from 12.18/100,000 in 1990 to 22.42/100,000 in 2017. The standardized prevalence rate of CRC significantly increased from 44.55/100,000 in 1990 to 118.40/100,000 in 2017. The trend of the prevalence rate in both genders grow higher in 2017 compared to the 1990, resulting in 141.6%, 209.8% and 189.0% for the studied three age groups (15−49, 50−69 and 70+ years old), respectively. The death rate increased in the age groups of 50−69 and 70+ years in both genders (8.6% and 31.0% respectively), in contrast to a decrease of death rate in the age group of 15−49 years old (−10.8%).

Conclusions

China experienced a stunning increase in terms of incidence and prevalence rate of CRC from 1990 to 2017. To decrease the burden of CRC, prevention and management of known risk factors should be promoted through national polices.

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Most cited references 20

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Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)

This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.

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Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society

Kevin C Oeffinger, Ya-Chen Tina Shih, Louise C Walter … (2018)

In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model-recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation. The recommendation for regular screening in adults aged 50 years and older is a strong recommendation. The ACS recommends (qualified recommendations) that: 1) average-risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250-281. © 2018 American Cancer Society.

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[Report of cancer epidemiology in China, 2015].

R. S. Zheng, K. -X. Sun, S W Zhang … (2019)

Objective: Data from local cancer registries were pooled to estimate cancer incidence and mortality in China, 2015. Methods: Data submitted from 501 cancer registries were checked & evaluated according to the criteria of data quality control, and 368 registries' data were qualified for the final analysis. Data were stratified by area (urban/rural), sex, age group and cancer sites, and combined with national population data to estimate cancer incidence and mortality in China, 2015. Chinese population census in 2000 and Segi's population were used for age-standardized. Results: Total population covered by 368 cancer registries were 309 553 499 (148 804 626 in urban and 160 748 873 in rural areas). The percentage of morphologically verified cases (MV) and the percentage of death certificate-only cases (DCO) accounted for 69.34% and 2.09%, respectively, and the mortality to incidence ratio was 0.61. About 3 929 000 new cancer cases were reported in 2015 and the crude incidence rate was 285.83 per 100 000 population (males and females were 305.47 and 265.21 per 100 000 population). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 190.64 and 186.39 per 100 000 population, respectively, with the cumulative incidence rate (0-74 age years old) of 21.44%. The cancer incidence and ASIRC were 304.96/100 000 and 196.09/100 000 in urban areas and 261.40/100 000 and 182.70/100 000 in rural areas, respectively. About 2 338 000 cancer deaths were reported in 2015 and the cancer mortality was 170.05/100 000 (210.10/100 000 in males and 128.00/100 000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 106.72/100 000 and 105.84/100 000, respectively, with the cumulative incidence rate (0-74 age years old) of 11.94%. The cancer mortality and ASMRC were 172.61/100 000 and 103.65/100 000 in urban areas and 166.79/100 000 and 110.76/100 000 in rural areas, respectively. The most common cancer cases including lung, gastric, colorectal, liver and female breast, the top 10 cancer incidence accounted for about 76.70% of all cancer new cases. The most common cancer deaths including lung, liver, gastric, esophageal and colorectal, the top 10 cancer deaths accounted for about 83.00% of all cancer deaths. Conclusions: The burden of cancer showed a continuous upward trend in China. Cancer prevention and control faces the problem of the disparity in different areas and different cancer burden between men and women. The cancer pattern in China presents the coexistence of the cancer patterns in developed and developing countries. The situation of cancer prevention and control is still serious in China.

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Author and article information

Contributors

Xin Gao

Zhongtao Zhang

Journal

Journal ID (nlm-ta): Chin J Cancer Res

Journal ID (iso-abbrev): Chin. J. Cancer Res

Journal ID (publisher-id): CJCR

Title: Chinese Journal of Cancer Research

Publisher: AME Publishing Company

ISSN (Print): 1000-9604

ISSN (Electronic): 1993-0631

Publication date (Print): June 2019

Volume: 31

Issue: 3

Pages: 489-498

Affiliations

[1 ] Department of General Surgery, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing 100050, China

[2 ] National Center for Chronic and Noncommunicable Disease Control and Prevention (NCNCD), Chinese Center for Disease Control and Prevention (CDC), Beijing 100050, China

Author notes

Prof. Xin Gao. National Center for Chronic and Noncommunicable Disease Control and Prevention (NCNCD), Chinese Center for Disease Control and Prevention (CDC), No. 27 Nanwei Road, Xicheng District, Beijing 100050, China. Email: gaoxin@ 123456ncncd.Chinacdc.cn

Prof. Zhongtao Zhang. Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center of Digestive Diseases, No. 95 Yong’an Road Xicheng District, Beijing 100050, China. Email: zhangzht@ 123456medmail.com.cn

Article

Publisher ID: cjcr-31-3-489

DOI: 10.21147/j.issn.1000-9604.2019.03.11

PMC ID: 6613508

PubMed ID: 31354218

SO-VID: b25fc3eb-9f7f-4ae0-9111-42409308cf4c

License:

This work is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

Burden of colorectal cancer in China, 1990 −2017: Findings from the Global Burden of Disease Study 2017

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Abstract

Objective

Methods

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Most cited references 20

Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society

[Report of cancer epidemiology in China, 2015].

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