Global patterns and trends in colorectal cancer incidence and mortality
Global patterns and trends in colorectal cancer incidence and mortality
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DOI：
10.1136/gutjnl-2015-310912
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发表时间：
2017-04-01
期刊：
影响因子：
24.5
通讯作者：
Bray, Freddie
中科院分区：
文献类型：
--
作者：
Arnold, Melina;Sierra, Monica S.;Bray, Freddie
到2030年，结直肠癌（CRC）的全球负担预计将增加60%，超过220万新发病例和110万例死亡。在这项研究中，我们的目的是描述最近的CRC发病率和死亡率的模式和趋势，将研究结果与通过癌症预防和护理减轻负担的前景联系起来。利用《五大洲癌症发病率》第一至十卷和世卫组织死亡率数据库的数据，对37个国家的时间模式进行了评估。趋势进行了评估，通过每年的百分比变化，使用joinpoint回归和讨论有关人类发展levels.Results CRC发病率和死亡率变化高达10倍的世界范围内，不同梯度的人类发展水平，对扩大差距和增加负担，在转型期国家。一般来说，CRC的发病率和死亡率仍在迅速上升，在许多低收入和中等收入的国家，稳定或下降的趋势往往被认为是在高度发达的国家，利率仍然是世界上最高的。结论CRC的发病率和死亡率的模式和趋势与目前的人类发展水平和他们的增量变化可能反映了采用更西方的生活方式。需要有针对性的资源依赖性干预措施，包括低收入人群的初级预防，以及高收入人群的早期发现，以减少未来几十年CRC患者的数量。
Objective The global burden of colorectal cancer (CRC) is expected to increase by 60% to more than 2.2 million new cases and 1.1 million deaths by 2030. In this study, we aim to describe the recent CRC incidence and mortality patterns and trends linking the findings to the prospects of reducing the burden through cancer prevention and care.Design Estimates of sex-specific CRC incidence and mortality rates in 2012 were extracted from the GLOBOCAN database. Temporal patterns were assessed for 37 countries using data from Cancer Incidence in Five Continents (CI5) volumes I-X and the WHO mortality database. Trends were assessed via the annual percentage change using joinpoint regression and discussed in relation to human development levels.Results CRC incidence and mortality rates vary up to 10-fold worldwide, with distinct gradients across human development levels, pointing towards widening disparities and an increasing burden in countries in transition. Generally, CRC incidence and mortality rates are still rising rapidly in many low-income and middle-income countries; stabilising or decreasing trends tend to be seen in highly developed countries where rates remain among the highest in the world.Conclusions Patterns and trends in CRC incidence and mortality correlate with present human development levels and their incremental changes might reflect the adoption of more western lifestyles. Targeted resource-dependent interventions, including primary prevention in low-income, supplemented with early detection in high-income settings, are needed to reduce the number of patients with CRC in future decades.