{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:24:09Z","timestamp":1790688249702,"version":"4.1.0"},"reference-count":86,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sichuan Provincial Science and Technology Plan Key R&D Project","award":["2024YFFK0348"],"award-info":[{"award-number":["2024YFFK0348"]}]},{"name":"General Project of Humanities and Social Sciences Research of the Ministry of Education","award":["24YJAZH217"],"award-info":[{"award-number":["24YJAZH217"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Colorectal cancer (CRC) poses a significant health challenge in East Asia. This study examined long-term trends in CRC incidence, mortality and disability-adjusted life years (DALYs) and their key drivers across five East Asian countries (China, Japan, South Korea, North Korea and Mongolia) from 1990\u20132021.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using Global Burden of Disease Study 2021 data, we assessed temporal trends using joinpoint regression, age\/period\/birth cohort effects through age-period-cohort analysis, and key drivers via decomposition analysis; we also evaluated associations between CRC burden and the Socio-Demographic Index (SDI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Between 1990 and 2021, descriptive analysis showed CRC age-standardised incidence rates (ASIRs) increased in all East Asian countries, while age-standardised mortality rates (ASMRs) and age-standardised DALY rates (ASDRs) generally declined, although 95% uncertainty intervals (UIs) overlapped in some countries. Joinpoint regression revealed overall increasing ASIR trends, with South Korea showing the largest average annual percentage changes (AAPCs) (males 2.18%, females 1.41%). ASMRs and ASDRs generally decreased, particularly among females; however, Mongolian males experienced slight increases (ASMR AAPC\u2009=\u20090.50%; ASDR AAPC\u2009=\u20090.44%). Relative risks for CRC incidence, mortality and DALYs increased with age, peaking in older groups. Period effects increased approximately linearly, while cohort effects decreased for younger generations. Decomposition analysis showed ageing and population growth were the main contributors to increased CRC burden. SDI showed an overall positive association with CRC burden, with heterogeneity by country and sex.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Joinpoint analysis (1990\u20132021) demonstrated increases in CRC incidence (predominantly males) and declines in mortality\/DALY rates (especially females) across most East Asian countries; however, substantial changes (non-overlapping UIs) were limited to few groups, warranting cautious interpretation. Despite progress, the persistent overall burden remains substantial, mainly driven by ageing and population growth. These findings underscore the need for country- and sex-specific prevention, screening, and lifestyle strategies.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0334229","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T17:45:31Z","timestamp":1759945531000},"page":"e0334229","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trends in incidence, mortality and disability-adjusted life years of colorectal cancer in East Asia (1990\u20132021): An analysis of the Global Burden of Disease study 2021"],"prefix":"10.1371","volume":"20","author":[{"given":"Yuanyi","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luhan","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyao","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengxing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingbi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6166-1601","authenticated-orcid":true,"given":"Junhui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"issue":"3","key":"pone.0334229.ref001","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"F Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"issue":"2","key":"pone.0334229.ref002","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1136\/gutjnl-2022-327736","article-title":"Global burden of colorectal cancer in 2020 and 2040: incidence and mortality estimates from GLOBOCAN","volume":"72","author":"E Morgan","year":"2023","journal-title":"Gut"},{"issue":"7","key":"pone.0334229.ref003","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S2468-1253(19)30147-5","article-title":"Changes in colorectal cancer incidence in seven high-income countries: a population-based study","volume":"4","author":"M Araghi","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"1","key":"pone.0334229.ref004","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1053\/j.gastro.2020.02.068","article-title":"Global Burden of 5 Major Types of Gastrointestinal Cancer","volume":"159","author":"M Arnold","year":"2020","journal-title":"Gastroenterology"},{"issue":"7","key":"pone.0334229.ref005","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/S2468-1253(22)00044-9","article-title":"Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"7","author":"GBD 2019 Colorectal Cancer Collaborators","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"issue":"5","key":"pone.0334229.ref006","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1038\/s41575-022-00726-3","article-title":"Updated epidemiology of gastrointestinal cancers in East Asia","volume":"20","author":"J Huang","year":"2023","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"pone.0334229.ref007","first-page":"83","article-title":"The nutrition transition in developing Asia: Dietary change, drivers and health impacts.","author":"M. 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