Trends and Projections of Early-Onset Colorectal Cancer Burden in China, 1990-2036: Findings From the Global Burden of Disease 2021 Study

BackgroundThe incidence and prevalence of early-onset colorectal cancer (EO-CRC), defined as colorectal cancer diagnosed before the age of 50, are increasing globally. However, the current status and trends of the disease burden of EO-CRC in China, including incidence, prevalence, mortality, and disability-adjusted life-years (DALYs), are not well understood. This study aimed to analyze the epidemiological trends of EO-CRC in China from 1990 to 2021 and to project its future burden.MethodsWe analyzed data from the Global Burden of Disease (GBD) 2021 study to assess the trends in incidence, prevalence, mortality, and DALYs of EO-CRC in China from 1990 to 2021. Joinpoint regression analysis was used to identify significant changes in trends. Age-period-cohort (APC) analysis was conducted to disentangle the effects of age, period, and birth cohort. The Bayesian APC model was employed to project the burden of EO-CRC up to 2036.ResultsFrom 1990 to 2021, the absolute number of EO-CRC incident and prevalent cases in China increased substantially. The age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR) also rose significantly, with an accelerated increase after 2007 in men and after 2015 in women. In contrast, the age-standardized mortality rate (ASMR) and age-standardized DALYs rate (AS-DALYs) generally declined; however, a concerning reversal of this trend has been observed in recent years. Incidence, prevalence, mortality and DALYs rates all showed significant age, period, and cohort effects. Projections indicate that ASIR and ASPR will continue to rise until 2036, especially in males, and the disparity in disease burden between men and women is expected to widen.ConclusionThe disease burden of EO-CRC in China has increased significantly and is rising rapidly, particularly among males. Further research is essential to fully understand the factors contributing to the increased incidence of EO-CRC and to develop effective mitigation strategies.