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Abstract：
BACKGROUND: The death burden attributable to modifiable risk factors is key to colorectal cancer (CRC) prevention. This study aimed to assess the prevalence and regional distribution of attributable CRC death burden worldwide from 1990 to 2019.
METHODS: We extracted data from the Global Burden of Disease Study in 2019 and assessed the mortality, age-standardized death rate (ASDR), population attributable fractions, and time trend in CRC attributable to risk factors by geography, socio-demographic index (SDI) quintile, age, and sex.
RESULTS: Over the past 30 years, from high to low SDI region, the number of deaths increased by 46.56%, 103.55%, 249.64%, 231.89%, 163.11%, and the average annual percentage change (AAPC) for ASDR were -1.06%, -0.01%, 1.32%, 1.19%, and 0.65%, respectively. ASDR in males was 1.88 times than in females in 2019; ASDR in males showed an increasing trend (AAPC 0.07%), whereas ASDR in females showed a decreasing trend (AAPC -0.69%) compared to figures in 1990. In 2019, from high to low SDI region, the 15-49 age group accounted for 3%, 6%, 10%, 11%, and 15% of the total population; dietary and metabolic factors contributed 43.4% and 20.8% to CRC-attributable death worldwide. From high to low SDI region, ASDRs caused by dietary and metabolic factors increased by -23.4%, -5.5%, 25.8%, 29.1%, 13.5%, and 1.4%, 33.3%, 100.8%, 128.4%, 77.7% respectively, compared to 1990.
CONCLUSIONS: The attributable CRC death burden gradually shifted from higher SDI to lower SDI regions. The limitation in males was more significant, and the gap is expected to be further expanded. In lower SDI regions, the death burden tended to affect younger people. The leading cause of CRC-attributable deaths was the inadequate control of dietary and metabolic risk factors.
METHODS: We extracted data from the Global Burden of Disease Study in 2019 and assessed the mortality, age-standardized death rate (ASDR), population attributable fractions, and time trend in CRC attributable to risk factors by geography, socio-demographic index (SDI) quintile, age, and sex.
RESULTS: Over the past 30 years, from high to low SDI region, the number of deaths increased by 46.56%, 103.55%, 249.64%, 231.89%, 163.11%, and the average annual percentage change (AAPC) for ASDR were -1.06%, -0.01%, 1.32%, 1.19%, and 0.65%, respectively. ASDR in males was 1.88 times than in females in 2019; ASDR in males showed an increasing trend (AAPC 0.07%), whereas ASDR in females showed a decreasing trend (AAPC -0.69%) compared to figures in 1990. In 2019, from high to low SDI region, the 15-49 age group accounted for 3%, 6%, 10%, 11%, and 15% of the total population; dietary and metabolic factors contributed 43.4% and 20.8% to CRC-attributable death worldwide. From high to low SDI region, ASDRs caused by dietary and metabolic factors increased by -23.4%, -5.5%, 25.8%, 29.1%, 13.5%, and 1.4%, 33.3%, 100.8%, 128.4%, 77.7% respectively, compared to 1990.
CONCLUSIONS: The attributable CRC death burden gradually shifted from higher SDI to lower SDI regions. The limitation in males was more significant, and the gap is expected to be further expanded. In lower SDI regions, the death burden tended to affect younger people. The leading cause of CRC-attributable deaths was the inadequate control of dietary and metabolic risk factors.
摘要：
背景：可改变的危险因素导致的死亡负担是预防结直肠癌（CRC）的关键。这项研究旨在评估1990年至2019年全球可归因CRC死亡负担的患病率和区域分布。
方法：我们从2019年的全球疾病负担研究中提取了数据，并评估了死亡率，年龄标准化死亡率（ASDR），人口归因分数，和由地理因素引起的CRC的时间趋势，社会人口统计学指数(SDI)五分之一，年龄,和性爱。
结果：在过去的30年里，从高SDI到低SDI区域，死亡人数增加了46.56%,103.55%,249.64%，231.89%,163.11%,ASDR的年均百分比变化(AAPC)为-1.06%，-0.01%，1.32%，1.19%，和0.65%，分别。2019年男性ASDR是女性的1.88倍；男性ASDR呈上升趋势（AAPC0.07%），与1990年的数字相比，女性的ASDR呈下降趋势（AAPC-0.69％）。2019年，从高到低SDI区域，15-49岁年龄组占3%，6%,10%,11%,占总人口的15%;饮食和代谢因素对全世界CRC归因死亡的贡献率分别为43.4%和20.8%.从高SDI到低SDI区域，由饮食和代谢因素引起的ASDR增加了-23.4％，-5.5%，25.8%,29.1%,13.5%,和1.4%，33.3%,100.8%,128.4%,分别为77.7%，与1990年相比。
结论：可归因的CRC死亡负担逐渐从较高的SDI转移到较低的SDI区域。男性的局限性更大，差距有望进一步扩大。在SDI较低的地区，死亡负担往往会影响年轻人。CRC归因死亡的主要原因是饮食和代谢危险因素控制不足。
方法：我们从2019年的全球疾病负担研究中提取了数据，并评估了死亡率，年龄标准化死亡率（ASDR），人口归因分数，和由地理因素引起的CRC的时间趋势，社会人口统计学指数(SDI)五分之一，年龄,和性爱。
结果：在过去的30年里，从高SDI到低SDI区域，死亡人数增加了46.56%,103.55%,249.64%，231.89%,163.11%,ASDR的年均百分比变化(AAPC)为-1.06%，-0.01%，1.32%，1.19%，和0.65%，分别。2019年男性ASDR是女性的1.88倍；男性ASDR呈上升趋势（AAPC0.07%），与1990年的数字相比，女性的ASDR呈下降趋势（AAPC-0.69％）。2019年，从高到低SDI区域，15-49岁年龄组占3%，6%,10%,11%,占总人口的15%;饮食和代谢因素对全世界CRC归因死亡的贡献率分别为43.4%和20.8%.从高SDI到低SDI区域，由饮食和代谢因素引起的ASDR增加了-23.4％，-5.5%，25.8%,29.1%,13.5%,和1.4%，33.3%,100.8%,128.4%,分别为77.7%，与1990年相比。
结论：可归因的CRC死亡负担逐渐从较高的SDI转移到较低的SDI区域。男性的局限性更大，差距有望进一步扩大。在SDI较低的地区，死亡负担往往会影响年轻人。CRC归因死亡的主要原因是饮食和代谢危险因素控制不足。
