BackgroundThe 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.MethodsWe 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.ResultsOver 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.ConclusionsThe 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.

中文翻译：

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可改变危险因素导致的结直肠癌死亡负担、1990-2019年趋势分析及未来预测

背景可改变的危险因素导致的死亡负担是结直肠癌（CRC）预防的关键。本研究旨在评估1990年至2019年全球范围内归因CRC死亡负担的患病率和区域分布。方法我们从2019年全球疾病负担研究中提取数据，并评估死亡率、年龄标准化死亡率（ASDR）、人口归因分数，以及按地理、社会人口指数（SDI）五分位数、年龄和性别划分的危险因素导致的 CRC 时间趋势。 结果 过去 30 年，从高 SDI 地区到低 SDI 地区，死亡人数增加了 46.56%、103.55 ASDR 的百分比、249.64%、231.89%、163.11% 和平均年百分比变化 (AAPC) 分别为 -1.06%、-0.01%、1.32%、1.19% 和 0.65%。 2019年男性ASDR是女性的1.88倍；与1990年相比，男性ASDR呈上升趋势（AAPC 0.07%），而女性ASDR呈下降趋势（AAPC -0.69%）。2019年，从SDI高到低的区域，15-49岁年龄组占比占总人口的 3%、6%、10%、11% 和 15%；饮食和代谢因素在全球 CRC 死亡中分别占 43.4% 和 20.8%。从高到低SDI区域，饮食和代谢因素引起的ASDR分别增加了-23.4%、-5.5%、25.8%、29.1%、13.5%和1.4%、33.3%、100.8%、128.4%、77.7%，与 1990 年相比。结论 可归因的 CRC 死亡负担逐渐从 SDI 较高的地区转移到 SDI 较低的地区。男性的限制更为显着，并且差距预计将进一步扩大。在 SDI 较低的地区，死亡负担往往会影响年轻人。结直肠癌死亡的主要原因是饮食和代谢危险因素控制不充分。