■已经观察到早发性结直肠癌(CRC)负担的上升趋势,但饮食风险导致的早发性CRC的分布和时间模式仍不清楚.
■本研究旨在估计全球饮食风险因素引起的早发性CRC的负担,区域性,在全国范围内,按年龄和性别,从1990年到2019年。
■饮食相关的早发性CRC负担的绝对数量和年龄特异性比率(ASR),以及可归因于饮食危险因素的总暴露值(SEV),摘自2019年全球疾病负担(GBD)研究。通过计算负担的绝对数量的百分比变化和负担的ASR的估计年度百分比变化(EAPC),分析了1990年至2019年负担的时间变化。计算年度变化率(ARC)以评估SEV的变化趋势。
■2019年,与饮食相关的早发性CRC在全球范围内导致30,096例(95%UI:23,148至36,091例)死亡病例和1,465,755例(95%UI:1,126,489至1,761例)DALYs,占总的早发性CRC的34.8%的死亡和34.4%的DALYs,分别。此外,低奶饮食(占2019年DALYs的16.5%[95%UI:11.1%至21.9%]),全谷物含量低(15.2%[95%UI:5.9至19.9%]),钙含量低(14.3%[95%UI:10.7至18.9%]),红肉含量高(5.3%[95%UI:1.7至9.5%]),加工肉类含量高(2.5%[95%UI:0.9至4.0%]),低纤维(2.3%[95%UI:0.9~4.2%])是早发性CRC可归因于饮食的危险因素.在1990年至2019年期间,归因于每种饮食风险因素的早发性CRC的特定年龄DALYs率总体上呈增长趋势,除了纤维摄入量低(EAPC=-0.57,95%CI:-0.76至-0.38)。此外,从1990年到2019年,男性的负担高于女性,而且由于大多数饮食风险因素的性别差异越来越大,这一差距可能会继续扩大.此外,由饮食风险引起的早发性CRC负担已经从具有高社会人口统计学指数(SDI)的地区转移到具有不受控制的饮食风险的高、中、中SDI五分位数.
■早发性CRC仍然是全球关注的问题,有效预防和改变饮食危险因素对减轻早发性CRC相关负担大有希望。男性饮食改善的优先地位对于CRC控制工作至关重要和紧迫。特别是对于那些生活在正在进行膳食模式转变的发展中国家。
UNASSIGNED: Rising trends in early-onset colorectal cancer (CRC) burden have been observed, but the distribution and temporal patterns of early-onset CRC attributable to dietary risks remain unclear.
UNASSIGNED: This study aimed to estimate the burden of early-onset CRC attributable to dietary risk factors globally, regionally, and nationally, by age and sex, from 1990 to 2019.
UNASSIGNED: The absolute number and age-specific rates (ASR) of diet-related early-onset CRC burden, as well as summary exposure value (SEV) of attributable dietary risk factors, were extracted from the Global Burden of Disease (GBD) Study 2019. The temporal changes in the burden between 1990 and 2019 were analyzed by calculating the percentage change in the absolute number of burden and the estimated annual percentage change (EAPC) in ASR of burden. The annualized rates of change (ARC) were calculated to evaluate the variation trend of SEV.
UNASSIGNED: In 2019, diet-related early-onset CRC caused 30,096 (95% UI: 23,148 to 36,091) death cases and 1,465,755 (95% UI: 1,126,489 to 1,761,661) DALYs worldwide, accounting for 34.8% deaths and 34.4% DALYs of overall early-onset CRC, respectively. Moreover, a diet low in milk (responsible for 16.5% [95% UI: 11.1 to 21.9%] of DALYs in 2019), low in whole grains (15.2% [95% UI: 5.9 to 19.9%]), low in calcium (14.3% [95% UI: 10.7 to 18.9%]), high in red meat (5.3% [95% UI: 1.7 to 9.5%]), high in processed meat (2.5% [95% UI: 0.9 to 4.0%]), and low in fiber (2.3% [95% UI: 0.9 to 4.2%]) were early-onset CRC attributable dietary risk factors. The age-specific DALYs rate of early-onset CRC attributable to each dietary risk factor generally showed an increasing trend globally between 1990 and 2019, except for low intake of fiber (EAPC = -0.57, 95% CI: -0.76 to -0.38). In addition, from 1990 to 2019, males have a higher burden than females and this gap may continue to widen due to the increasing difference between the sexes in most dietary risk factors. Furthermore, dietary risks-attributable early-onset CRC burden has shifted from regions with high socio-demographic index (SDI) to high-middle and middle SDI quintiles with uncontrolled dietary risks.
UNASSIGNED: Early-onset CRC remains a concerning issue globally, and effective prevention and modification of dietary risk factors holds great promise to reduce early-onset CRC-related burden. Prioritizing diet improvement for males is critical and urgent for CRC control efforts, particularly for those living in developing countries with ongoing dietary pattern transition.