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Peer-reviewedCC BY 4.0Frontiers in Oncology

Early-onset colorectal cancer burden in China from 1990 to 2023: a systematic analysis based on the Global Burden of Disease Study 2023

  • Haijian Wei1
  • Hao Wu2,3
  • Shuai Wang4
  • Yiwei Yao2
  • Kaiwen Zheng5
  • Zhini Yang6
  • Jianan Ma7
7 affiliations
  1. 1Department of Organ Transplantation, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
  2. 2Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun, China
  3. 3Department of Urology, The First Hospital of Jilin University, Changchun, China
  4. 4Department of Gastric and Colorectal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, China
  5. 5Cancer Center, The First Hospital of Jilin University, Changchun, China
  6. 6Anaesthesiology, Medical College of Yanbian University, Yanji, China
  7. 7Department of Pathology, School of Basic Medical Sciences, Shandong Medical and Pharmaceutical University, Yantai, China
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Abstract

Background: Early-onset colorectal cancer (EOCRC) impairs the health of China’s working-age population and causes substantial socioeconomic costs. National long-term epidemiological data integrating trend segmentation, risk attribution and medium-term forecasting for domestic EOCRC remain insufficient. This study analysed China’s 33-year EOCRC burden (1990-2023), identified trend inflection points, quantified modifiable risk-attributable burden and predicted epidemic trends to support tiered prevention strategies.

Methods: Data on EOCRC burden among Chinese residents aged 15–49 were derived from the Global Burden of Diseases, Injuries, and Risk Factors Study 2023. We analyzed absolute cases and age-standardized rates of incidence, mortality, DALYs and prevalence. Joinpoint regression detected segmented nonlinear trends, and Autoregressive integrated moving average (ARIMA) models projected burden for 2024-2040. Dietary, metabolic and behavioural risk-attributable burden was quantified.

Results: From 1990 to 2023, national EOCRC mortality and DALY burden decreased continuously, whereas incident and prevalent cases increased significantly. Gender and age gradients existed: males and residents aged 45–49 carried the highest disease burden with slower improvement. Low milk and whole grain intake were the leading risk contributors, while high processed meat and high BMI showed rapidly rising attributable burden. All four burden indicators presented multi-stage trends and rebounded after 2020. ARIMA forecasts indicated age-standardized mortality and DALY rates would keep decreasing by 2040, yet male-dominated burden gaps remain prominent.

Conclusion: China’s EOCRC presents divergent long-term burden trends and stable age-sex disparities. The high burden in the 45–49 age group supports prioritizing this population for further screening evaluation, and male-oriented lifestyle interventions may help curb growing incidence and alleviate youth colorectal cancer burden.

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Cite

BibTeXRIS
BibTeX
@article{wei2026earlyonset,
  title = {{Early-onset colorectal cancer burden in China from 1990 to 2023: a systematic analysis based on the Global Burden of Disease Study 2023}},
  author = {Haijian Wei and Hao Wu and Shuai Wang and Yiwei Yao and Kaiwen Zheng and Zhini Yang and Jianan Ma},
  journal = {Frontiers in Oncology},
  year = {2026},
  month = oct,
  doi = {10.3389/fonc.2026.1958227},
  url = {https://doi.org/10.3389/fonc.2026.1958227},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Early-onset colorectal cancer burden in China from 1990 to 2023: a systematic analysis based on the Global Burden of Disease Study 2023
AU  - Haijian Wei
AU  - Hao Wu
AU  - Shuai Wang
AU  - Yiwei Yao
AU  - Kaiwen Zheng
AU  - Zhini Yang
AU  - Jianan Ma
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Oncology
DO  - 10.3389/fonc.2026.1958227
UR  - https://doi.org/10.3389/fonc.2026.1958227
AB  - Background: Early-onset colorectal cancer (EOCRC) impairs the health of China’s working-age population and causes substantial socioeconomic costs. National long-term epidemiological data integrating trend segmentation, risk attribution and medium-term forecasting for domestic EOCRC remain insufficient. This study analysed China’s 33-year EOCRC burden (1990-2023), identified trend inflection points, quantified modifiable risk-attributable burden and predicted epidemic trends to support tiered prevention strategies.  Methods: Data on EOCRC burden among Chinese residents aged 15–49 were derived from the Global Burden of Diseases, Injuries, and Risk Factors Study 2023. We analyzed absolute cases and age-standardized rates of incidence, mortality, DALYs and prevalence. Joinpoint regression detected segmented nonlinear trends, and Autoregressive integrated moving average (ARIMA) models projected burden for 2024-2040. Dietary, metabolic and behavioural risk-attributable burden was quantified.  Results: From 1990 to 2023, national EOCRC mortality and DALY burden decreased continuously, whereas incident and prevalent cases increased significantly. Gender and age gradients existed: males and residents aged 45–49 carried the highest disease burden with slower improvement. Low milk and whole grain intake were the leading risk contributors, while high processed meat and high BMI showed rapidly rising attributable burden. All four burden indicators presented multi-stage trends and rebounded after 2020. ARIMA forecasts indicated age-standardized mortality and DALY rates would keep decreasing by 2040, yet male-dominated burden gaps remain prominent.  Conclusion: China’s EOCRC presents divergent long-term burden trends and stable age-sex disparities. The high burden in the 45–49 age group supports prioritizing this population for further screening evaluation, and male-oriented lifestyle interventions may help curb growing incidence and alleviate youth colorectal cancer burden.
SN  - 2234-943X
ER  -