Shifts in the landscape of colorectal cancer burden: A systematic analysis using the global burden of disease and SEER databases.

Abstract

e15699 Background: Colorectal cancer (CRC) is the third most diagnosed cancer and the second leading cause of cancer-related deaths worldwide. However, there is a lack of direct comparisons between global CRC trends and those in the U.S. This study examines data from the Global Burden of Disease (GBD 2021) and Surveillance, Epidemiology, and End Results (SEER) databases to analyze trends in CRC incidence, mortality, and Disability-Adjusted Life Years (DALYs) over the last twenty years. Methods: We utilized the GBD 2021 database to extract data on global trends in CRC and the SEER Research Data, 17 Registries Nov 2023 Sub (2000–2021) for CRC trends in the U.S. Global CRC incidence, mortality, and DALYs were assessed using the GBD 2021 database. U.S. incidence trends were examined with SEER*Stat software. Annual Percent Change (APC) was determined using Joinpoint regression to evaluate age-specific trends, with APCs calculated through the weighted least squares method. Results: Globally, the APC in CRC incidence increases with age, starting at –0.38 in younger individuals (15–19 years) and reaching a peak of 3.86 in those aged 85 and older. Likewise, the APC for DALYs and mortality shows an age-dependent increase, indicating a growing health burden among older populations. The lowest mortality APC is found in the 15–19 age group (–1.51), while the highest is observed in those aged 85+ (3.5). Similarly, the DALY APC follows this trend, with the lowest in the 15–19 age group (–1.49) and the highest in the 85+ group (3.47). In contrast, SEER data from the U.S. highlights a different trend. Younger age groups, like those aged 15–19, exhibit a significantly high APC in CRC incidence of 11.5 (95% CI: 8.9–14.3), signaling a concerning rise in diagnoses. This pattern differs from global data, where APCs in younger populations are either stable or declining. For older U.S. populations, the APC consistently decreases with age, turning negative in individuals aged 70 and above. The most significant APC reductions are seen in the 75–79 and 80–84 age groups showing a value of –2.6(95% CI: -3.0 to -2.2) and -2.6(95% CI: -2.9 to -2.3) respectively. Conclusions: The global rates of CRC incidence, mortality, and overall impact are increasing, especially among older populations. However, CRC rates are rising significantly in younger people in the U.S., which is concerning. The factors behind this shift in younger populations need more exploration. Healthcare professionals should be mindful of these age-related differences. If the trend persists, it may be necessary to reevaluate existing CRC screening guidelines to better address the growing impact on younger individuals.