Global, Regional, and National Disease Burden and Prediction Analysis of Colorectal Cancer Attributable to Tobacco, Alcohol, and Obesity From 1990 to 2030
Original research article
Key findings
Smoking, alcohol consumption, and obesity are the primary modifiable risk factors closely associated with CRC.
Colorectal cancer (CRC) is still a serious public health concern that needs immediate worldwide attention and consideration.
From 2020 to 2030, the global age-standardized mortality rate for colorectal cancer linked to alcohol use in men is expected to rise by 8.88%
In regions with varying Socio-Demographic Index levels, the age-standardized mortality rate of colorectal cancer due to alcohol consumption and smoking is significantly higher in males than females. The differences between genders remain significant, especially in high Socio-Demographic Index regions.
The study reveals an increasing trend in the burden of colorectal cancer due to smoking and alcohol consumption in younger age groups.
Research indicates that, from 1990 to 2019, the age-standardized mortality rate for colorectal cancer in people aged 65 to 74 is at its highest due to alcohol consumption, smoking, and obesity. This trend demonstrates a continuous increase in regions with medium-to-high and high Socio-Demographic Index levels. Older adults typically have longer exposure periods to risk factors such as smoking and alcohol consumption.
The study projects that China, India, and Tanzania will see an increase in the burden of colorectal cancer mortality linked to alcohol use and smoking. The trend is directly linked to inadequate policies for alcohol and tobacco regulation, as well as a lack of efficient colon cancer screening and early diagnosis procedures.
Therefore, lowering the burden of colorectal cancer mortality in these areas requires the adoption of efficient alcohol policy measures, the encouragement of healthy lifestyles, and the improvement of colorectal cancer screening and early detection.
The findings emphasize the importance of preventing colorectal cancer through the control of modifiable risk factors and highlight the necessity of developing targeted public health strategies in regions with differing Socio-Demographic Index levels.
Abstract
Background
Colorectal cancer (CRC) ranks among the highest in incidence and mortality rates globally. A significant portion of colorectal cancer cases and deaths can be attributed to modifiable risk factors, with smoking, alcohol use, and high body mass index (BMI) being the three most prominent. However, the impact of these risk factors on colorectal cancer across regions, genders, and age groups remains insufficiently characterized.
Methods
Utilizing data from the Global Burden of Disease (GBD) study 2019, restrictive cubic splines (RCS) and quantile regression analyses are applied to explore the relationship between the Socio-Demographic Index (SDI) and ASMR or ASDR. Additionally, gender differences, changes across different SDI levels, and age group trends in smoking, alcohol use, and high BMI over the 30-year period are analyzed.
The Bayesian age-period-cohort (BAPC) model is employed to predict mortality trends from 2020 to 2030, aiming to explore the epidemiological and sociodemographic transitions in the Colorectal cancer disease burden attributed to smoking, alcohol use, and high BMI.
Results
In 2019, the number of colorectal cancer deaths globally due to risk factors increased.
- Colorectal cancer deaths globally due to smoking increased to 142,931 cases.
- Colorectal cancer deaths globally due to alcohol consumption increased to 52,495 cases.
- Colorectal cancer deaths globally due to obesity increased to 85,882 cases.
Collectively deaths due to these three risk factors are accounting for approximately one-third of all colorectal cancer-related deaths.
Notably, there is an upward trend in early-onset colorectal cancer mortality associated with these factors.
Discussion
To reduce the burden of colorectal cancer, the researchers recommend to enhance health education, promote smoking cessation and alcohol “moderation”, and increase the coverage and participation in colorectal cancer screening, which are crucial for lowering colorectal cancer mortality rates.
These findings are vital for the development of public health policies and intervention measures to reduce the global disease burden. They provide guidance for colorectal cancer prevention across different regions, genders, and age groups worldwide.