Trends in disability-adjusted life years (DALY) from colorectal cancer in Germany: A lesson to be learned?

Abstract

e22543 Background: The incidence and prevalence of colorectal cancer (CRC) is on the rise globally and consequently Disability Adjusted Life Years (DALYs) from CRC are increasing as well. This trend is particularly seen in industrialized and "first world" nations, and it is primarily linked to obesity, processed food, physical inactivity, smoking, and alcohol. We report a rather peculiar decreasing trend in DALY attributable to CRC in Germany. Methods: The data from Global Burden of Disease (GBD) study 2021 was utilized. Trends in DALYs from colorectal cancer were analyzed across various regions and countries, with particular attention to Germany. Results: Linear regression analysis and non-parametric Kendall’s tau test were carried out on the data extracted from GBD study. Linear regression showed an average annual decline of approximately 5,400 DALYs per 100,000 population (p < 0.001). Non-parametric Kendall’s tau test also showed a strong negative monotonic trend (τ = −0.79, p < 0.001). Overall, these findings indicate a substantial and long-term reduction in disease burden from colorectal cancer in German population over the course of study population. Conclusions: Colorectal cancer is the third leading cause of mortality worldwide. Despite the advances in screening, diagnostic and therapeutic techniques, colorectal cancer is on the rise globally. Infact, globally new CRC cases are predicted to reach 3.2 million in 2040. It is attributable to obesity, long-term smoking, and high intake of red or processed meat. This trend is expected to translate into increased mortality and consequently increased DALY. However, our study shows a decreasing trend in DALYs from CRC in Germany, which is in most part attributable to aggressive screening strategies. Screening colonoscopy was introduced into German national statutory cancer screening program in 2002. And studies have shown that the incidence of CRC decreased by 17-26 % within 10 years of introduction of screening colonoscopy. This has in turn lead to decreased mortality and decreased DALY from colorectal cancer in Germany. DALY/100000 from colorectal cancer in Germany. Year DALY/100000 1990 711506.65 1993 729678.42 1996 741107.2 1999 677952.59 2002 674754.23 2005 646214.79 2011 603322.41 2014 584135.79 2017 595793.47 2021 586274.79