{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:59:02Z","timestamp":1791899942979,"version":"4.3.4"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early\u2010onset colorectal cancer (EO\u2010CRC) is increasing globally with substantial regional variation. We assessed epidemiological changes in EO\u2010CRC in five East Asian populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using GBD 2023 data, we calculated age\u2010standardized incidence, prevalence, mortality, and DALY rates (ASIR, ASPR, ASMR, ASDR), counts, and average annual percent changes (AAPC). Decomposition, age\u2010period\u2010cohort (APC), and forecast analyses assessed trends and risk factor contributions to mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2023, these populations accounted for 25%\u201331% of global EO\u2010CRC cases. China had the highest absolute burden, and Taiwan (Province of China) had the highest ASR. From 1990 to 2023, North Korea had the highest ASIR increase (AAPC\u2009=\u20091.34%), while South Korea's ASMR declined most (AAPC\u2009=\u2009\u22122.58%). Males had a higher burden than females. Decomposition analysis showed epidemiological changes increased incidence outside China but generally reduced mortality except in North Korea, with effects stronger for deaths than incidence. APC analysis revealed accelerated risk with age; period effects varied: North Korea showed the largest relative risk increase (RR 0.93\u2009\u2192\u20091.32), and China showed a post\u20102014 rebound. Projections to 2038 suggest continued rises in incidence and DALYs. Risk analysis identified low calcium intake as the main mortality driver in North Korea, and low milk, low whole grains, and high red meat intake in the other populations; high BMI and processed meat\u2013related deaths also increased markedly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EO\u2010CRC incidence is rising in East Asia, with China highest in absolute numbers and Taiwan in ASR; men are disproportionately affected. Burden and risk analyses reveal population\u2010specific effects. Interventions should target diet, screening, and sex\u2010 and population\u2010specific risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71905","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:00:08Z","timestamp":1777870808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Burden and Forecast of Early\u2010Onset Colorectal Cancer (1990\u20132038) in Five East Asian Populations: A Systematic Analysis Based on the\n                    <scp>GBD<\/scp>\n                    2023 Study"],"prefix":"10.1002","volume":"15","author":[{"given":"Lili","family":"jin","sequence":"first","affiliation":[{"name":"Department of General Surgery Zhejiang Hospital  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Zhejiang Hospital  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyang","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of General Surgery Zhejiang Hospital  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"liao","sequence":"additional","affiliation":[{"name":"Department of General Surgery Zhejiang Hospital  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6335-3739","authenticated-orcid":false,"given":"Baoqing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of General Surgery Zhejiang Hospital  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(24)00441-2"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571-022-00672-8"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.07.055"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02008"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-22-1038"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-20624-4"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2024.12.011"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41065-020-00162-w"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-025-15056-1"},{"key":"e_1_2_13_12_1","unstructured":"Network GBoDC \u201cGlobal Burden of Disease Study 2023 (GBD 2023) Socio\u2010Demographic Index (SDI) 1950\u20132023 \u201dSeattle United States of America2025."},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40364-024-00649-y"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.pu.12.050191.002233"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/03014460.2019.1707872"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2764"},{"key":"e_1_2_13_18_1","volume-title":"Standardization and Decomposition of Rates: A Users's Manual","author":"Gupta P. D.","year":"1993"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2018.04.011"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/sjg.sjg_376_25"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00685-8"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15194853"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-025-04086-5"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/CEJ.0000000000000963"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365529409091740"},{"issue":"5","key":"e_1_2_13_26_1","first-page":"600","article-title":"Status of Dietary Calcium Intake of Chinese Residents","volume":"36","author":"He Y.","year":"2007","journal-title":"Wei Sheng Yan Jiu = Journal of Hygiene Research"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2021.1911927"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13412"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12127"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13092025"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-14274-7"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16172931"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.02.016"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1210\/me.2010-0452"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30073-5"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)01637-X"},{"key":"e_1_2_13_37_1","unstructured":"Bank W \u201cGDP (constant LCU) 2024 \u201dhttps:\/\/data360.worldbank.org\/en\/indicator\/WB_WDI_NY_GDP_MKTP_KN?country=CHN&view=trend."},{"issue":"6","key":"e_1_2_13_38_1","first-page":"519","article-title":"Survey on Dietary Nutrients Intake of Chinese Residents Between 2010 and 2012","volume":"51","author":"Guo Q. Y.","year":"2017","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi [Chinese Journal of Preventive Medicine]"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28840"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2014.225"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20160036"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12579"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.6065\/apem.2017.22.4.231"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.4162\/nrp.2010.4.2.136"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2021.100205"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980020001226"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-024-08738-6"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2025.1433"}],"container-title":["Cancer Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71905","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cam4.71905","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cam4.71905","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:23:11Z","timestamp":1781583791000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cam4.71905"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/cam4.71905"],"URL":"https:\/\/doi.org\/10.1002\/cam4.71905","archive":["Portico"],"relation":{},"ISSN":["2045-7634","2045-7634"],"issn-type":[{"value":"2045-7634","type":"print"},{"value":"2045-7634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71905"}}