Trend analysis of early-onset colorectal cancer incidence in China based on GBD study 2021

Abstract Objective To investigate the overall trend in the incidence of early-onset colorectal cancer (EOCRC) in China from 1990 to 2021 and its relationship with age, period, and cohort effects, thereby providing data support for the development of early screening and targeted prevention measures. Methods This study is based on data from the Global Burden of Disease (GBD) 2021, evaluating the incidence trends of EOCRC in China from 1990 to 2021. An age–period–cohort (APC) model was employed to quantitatively analyze the impact of different age groups, periods, and birth cohorts on EOCRC incidence, thereby revealing the temporal trends of disease risk. Results The incidence of EOCRC in China increased significantly from 1990 to 2021. The number of cases rose from 33,990 (95% CI: 31,263–36,715) in 1990 to 78,128 (95% CI: 68,954–87,304) in 2021, reflecting a growth of roughly 130%. The age-standardized incidence rate per 100,000 people increased from 7.9 (95% UI: 6.6–9.3) to 14.9 (95% UI: 11.8–18.4). Net drift indicators show a higher annual growth rate in men (2.20%) compared to women (0.18%, p = 0.07). The APC analysis revealed a significant increase in EOCRC incidence among individuals aged over 25 and born after 1972 from 2005 to 2021. Additionally, between 1995 and 2005, the incidence risk for females was higher than that for males, whereas after 2005, males exhibited a higher incidence risk compared to females. Conclusions The incidence of EOCRC has increased significantly, underscoring the urgent need for early screening and targeted prevention measures to address this public health challenge.