Objective: Colorectal cancer (CRC) represents a significant public health challenge worldwide, with a particularly pronounced impact in East Asia. Considering the cultural, dietary, and lifestyle similarities and differences among China, Japan, and South Korea, this study specifically examines the burden of CRC in these three countries as well as globally. The aim is to elucidate the epidemiological trends and patterns in incidence, mortality, and disability-adjusted life years (DALYs) to provide a scientific foundation for the development of public health policies.
Methods: We analyzed CRC incidence, mortality, and DALYs from China, Japan, and South Korea (1990-2021) using Global Burden of Disease data (GBD 2021). We calculated Average Annual Percentage Change (AAPC) to track trends and used the Bayesian Age Period Cohort Prediction (BAPC) model to predict future CRC metrics. Decomposition analysis identified key factors affecting burden changes, and we assessed health inequities with the Slope Index of Inequality (SII) and the Concentration Index (CIX) across socio-economic groups.
Results: From 1990 to 2021, the burden of CRC significantly increased in China, Japan, South Korea, and globally, as measured by incidence, mortality, and DALYs. South Korea experienced the highest rise in incidence (AAPC = 5.29), followed by China (AAPC = 4.11), with Japan showing a relatively lower increase (AAPC = 2.71). South Korea also had the highest growth rates in mortality and DALYs, outpacing China and Japan. Gender-stratified analysis indicated that males in China and South Korea had faster increases in CRC incidence, mortality, and DALYs compared to females. For instance, South Korean males had an annual incidence growth rate of 5.82, compared to 4.66 for females. In Japan, males had higher growth rates in incidence and DALYs, but slightly lower mortality growth (AAPC = 2.36) than females (AAPC = 2.6). Decomposition analysis associated the increasing CRC burden with aging, especially among middle-aged and elderly populations. Socioeconomic factors also contributed significantly, with Japan showing higher crude DALY and mortality rates than other countries at similar Social Development Index (SDI) levels. Projections to 2050 suggest a continued rise in CRC incidence and mortality in China, while trends in South Korea and Japan are expected to stabilize, underscoring the need for tailored prevention strategies in each country.
Conclusion: Over the past three decades, CRC burden has surged in China, Japan, and South Korea, with South Korea seeing the sharpest rise in incidence and mortality. By 2050, China's CRC burden is projected to grow substantially, while South Korea stabilizes, and Japan's increase slows. These trends call for country-specific prevention strategies tailored to local epidemiological patterns. The findings provide critical evidence for public health policy, medical resource allocation, and targeted interventions, emphasizing the importance of enhanced early screening and CRC prevention.
Keywords: colorectal cancer (CRC); east asian countries; global burden of disease (GBD); public health policy.
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.