title: Epidemiological Trends in Colorectal Cancer in China: An Ecological Study.
abstract: 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.
authors: Department of Gastroenterology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
authors: Jinzhou
authors: J
authors: Zhu
authors: Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY, 14214, USA.
authors: Zhengqi
authors: Z
authors: Tan
authors: Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY, 14214, USA.
authors: Kelseanna
authors: K
authors: Hollis-Hansen
authors: Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY, 14214, USA.|School of Public Health and Health Management, Chongqing Medical University, Chongqing, 400016, China.
authors: Yong
authors: Y
authors: Zhang
authors: Department of Gastroenterology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China.
authors: Chaohui
authors: C
authors: Yu
authors: Department of Gastroenterology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China. ymli.zju@live.com.
authors: Youming
authors: 0000-0002-9771-6915
authors: Y
authors: Li
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011158:Population Growth; D015995:Prevalence; D019057:Quality-Adjusted Life Years; D012042:Registries; D017678:Sex Distribution
keywords: China; Colorectal cancer; Epidemiology; Incidence; Mortality