Global trend of colorectal cancer, prevention, and control in China: challenges and strategies

Abstract

<p indent="0mm">As the third most common malignancy worldwide and the second most deadly cancer, the global burden of colorectal cancer (CRC) is substantial and growing. It induced 1.93 million cases and 0.94 million deaths worldwide in 2020, accounting for 10% of the global cancer incidence and 9.4% of cancer deaths, just lower than lung cancer. With an alarming increase in cases of early-onset CRC, the situation of CRC in China is grim. In 2020, China recorded 560,000 new cases of CRC, accounting for 28.8% of global CRC cases, and 290,000 CRC deaths, accounting for 30.6% of global CRC deaths. The estimated number of CRC incident cases in China increased by 64%, from 0.56 million in 2020 to 0.91 million in 2040. CRC prevention and control in China faced severe challenges, such as the low population coverage ratio of the cancer registry, low population coverage of the screening programs, increased exposure to lifestyle risk factors, and a lack of public belief that CRC can be prevented. Coping strategies include the following: (1) The national policy is to tilte toward prevention, increase financial investment, and rapidly construct regional high-quality cancer monitoring sites in China. (2) Resource-based targeted interventions, including primary prevention among low-income people and early screening detection in high-income settings, are necessary. (3) All kinds of recreational physical activity should be encouraged, and healthy dietary patterns should be promoted. (4) The clinical practice of stratified CRC subtype mode should be promoted based on molecular biological characteristics and individualized minimally invasive precise CRC radical mode to maximize the treatment benefit of patients with CRC.