Epidemiological Trends in Colorectal Cancer in China: An Ecological Study

Due to the changes in lifestyle and dietary behaviors, the incidence of colorectal cancer (CRC) has been rapidly increasing in China. This study is to present the trends of CRC in China over the past decade. It used a series of nationally representative data, including the National Central Cancer Registry of China, the GLOBOCAN project and the Global Burden of Disease. The age-standardized rate of CRC incidence increased from 12.8 in 2003 to 16.8 per 100,000 in 2011, while the mortality rose from 5.9 to 7.8 per 100,000. The age group most affected by incident CRC cases were those aged 60-74 years old, whereas CRC death was most associated with those > 74 years. Furthermore, the east coast of China presented a higher mortality rate (> 15 and 10-14.9 per 100,000 in men and women) than central and west China (5-14.9 and 5-9.9 per 100,000). Compared with other countries worldwide, China indicated lower rates of incidence (14.2 per 100,000), mortality (7.4 per 100,000), and 5-year prevalence (52.7 per 100,000) than most developed countries. However, China had a higher case-fatality ratio (14.0 %) and mortality/incidence ratio (52.1 %). Lastly, disability-adjusted life years attributed to CRC in China was 224.2 per 100,000. It presents a steady increase in CRC in China over the past decade. It also reveals the domestic diversity of age, gender, and geography and finds the differences between China and developed countries, which may yield insights for national programs and policies.