Global patterns and temporal trends of colorectal cancer burden in older adults aged ≥ 70 years.

Abstract

e15685 Background: Colorectal cancer (CRC) is a major public health concern and represents the second leading cause of cancer-related deaths worldwide and is ranked as the third most common cancer. Despite the advancements in treatment approaches and preventive measures, this cancer remains prevalent in older adults aged ≥70 years. This study evaluates the global trends in Disability-Adjusted Life Years (DALYs), mortality and prevalence from 1990 to 2023 using the GBD (Global Burden of Disease) database. Methods: The Global Burden of Disease (2023) database was used to obtain the data. DALYs, mortality and prevalence rates per 100,000 population among adults aged 70 and older were assessed. We employed joinpoint regression analysis and estimated Annual Percentage Change (APC) for a particular period and Average Annual Percentage Change (AAPC) values for the entire study period. The statistical significance was assessed through p-values less than 0.05 with 95% confidence intervals. Results: DALYs rate per 100,000 increased non-significantly from 202.61 in 1990 to 207.65 in 1993 (APC: 0.69; 95% CI: -0.29 to 1.69; p < 0.16) followed by a significant decline to 197.52 (APC: -0.35; 95% CI: -0.43 to -0.27; p < 0.000001). Then rates increased gradually to 207.73 in 2020 (APC: 0.65; 95% CI: 0.49 to 0.80; p < 0.000001) followed by a sharp rise to 224.97 in 2023 (APC: 2.66; 95% CI: 1.65 to 3.67; p < 0.00001). The AAPC for DALYs rate was 0.346 (95% CI: 0.21 to 0.48; p < 0.000001) The mortality rate increased gradually from 5.29 per 100,000 in 1980 to 6.50 per 100,000 in 2023 with an AAPC of 0.518 (95% CI: 0.40 to 0.63; p < 0.000001). A continuous rise in prevalence rate was observed. From 1990 to 2023, the prevalence escalated from 52.62 per 100,000 in 1990 to 90.91 per 100,000 in 2023. A sharp incline in prevalence occured between 2020 to 2023 (APC:3.56; 95% CI: 2.45 to 4.67; p < 0.000001). Across the entire study period, the AAPC was 1.672 (95% CI: 1.45 to 1.89; p < 0.000001) for prevalence. Conclusions: The prevalence, mortality and DALYs in colorectal cancer in older adults have increased substantially over a study period from 1990 to 2023. This highlights an urgent need for strengthened age-appropriate screening programs, improve preventive strategies and optimize treatment approached to mitigate the disease burden in older adults. Mortality, Disability-Adjusted Life Years, and Prevalence Rates per 100,000 for Adults Aged ≥70 Years Due to Colorectal Cancer. (*shows p < 0.05). Year Mortality Rate (per 100,000) DALYs Rate (per 100,000) Prevalence Rate (per 100,000) 1980 5.293 – – 1990 5.768 202.610 52.623 2000 5.706 201.968 61.401 2010 5.624 197.996 72.162 2023 6.504 224.978 90.914 AAPC (entire period) 0.5183* 0.3463* 1.6726*