{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:52:28Z","timestamp":1783018348105,"version":"3.54.6"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe the spatiotemporal distribution characteristics of colorectal cancer (CRC) mortality in Chinese cancer registration areas and to predict its future trends, thereby providing an epidemiological basis for CRC prevention and control in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This study used cancer registry data from 2005 to 2018, collected from the China Cancer Registry Annual Report (2008\u20132021), to comprehensively describe CRC mortality patterns. Joinpoint regression models were employed to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to analyze temporal trends. The age\u2013period\u2013cohort model was used to disentangle the effects of age, period, and cohort. A Bayesian age\u2013period\u2013cohort (BAPC) model was constructed to predict future trends for 2019\u20132035. Global and local spatial autocorrelation methods were applied to describe the spatial distribution of CRC mortality and to identify high-risk areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2005 to 2018, in Chinese cancer registration areas, the mortality of CRC was 14.45\/100,000, and the age-standardized mortality rate (ASMR) was 11.13\/100,000 [95% confidence interval (CI): 11.03, 11.27]. From 2005 to 2007, the mortality rate of CRC showed an upward trend, with an APC of 3.67% (95% CI: \u22120.77%, 8.33%); from 2007 to 2013, there was a significant downward trend with an APC of \u22122.45% (95%CI: \u22123.14%, \u22121.47%); from 2013 to 2018, there was an upward trend with an APC of 0.13% (95% CI: \u22120.88%, 1.17%). From 2007 to 2013, the CRC mortality rates of different genders showed a significant downward trend. In urban areas from 2009 to 2018, the CRC mortality rate showed a significant downward trend with an APC of \u22121.21% (95% CI: \u22121.71%, \u22120.71%), but in rural areas, it showed a significant upward trend with an AAPC of 0.59% (95% CI: 0.24%, 1.56%). The age effects indicated that the risk of CRC death increased with age. From 2019 to 2035, the ASMR of CRC in Chinese cancer registration areas will generally show a slow upward trend. Spatial autocorrelation analysis showed that the mortality rate of CRC in Chinese cancer registration areas exhibited spatial clustering characteristics, with hotspots concentrated in the eastern coastal and northeastern provinces.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The mortality rate of CRC in Chinese cancer registration areas showed a trend of first increasing, then decreasing, and then increasing from 2005 to 2018. It was predicted that it will continue to rise from 2019 and still face a series of challenges such as urban-rural, gender, and regional inequality. In the future, more targeted prevention and control strategies should be adopted, combined with dietary and lifestyle interventions, to further reduce the burden of CRC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0352110","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:43:38Z","timestamp":1783014218000},"page":"e0352110","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatio-temporal patterns and prediction of colorectal cancer mortality in Chinese cancer registration areas: A nationwide study based on multiple models"],"prefix":"10.1371","volume":"21","author":[{"given":"Yu","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshuang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjiang","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Man","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3094-6574","authenticated-orcid":true,"given":"Jiageng","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"issue":"11","key":"pone.0352110.ref001","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.43198","article-title":"Global disparities of cancer and its projected burden in 2050","volume":"7","author":"HM Bizuayehu","year":"2024","journal-title":"Jama Netw Open"},{"key":"pone.0352110.ref002","unstructured":"Cancer today. https:\/\/gco.iarc.who.int\/media\/globocan\/factsheets\/cancers\/39-all-cancers-fact-sheet.pdf. Accessed 2025 August 29."},{"key":"pone.0352110.ref003","unstructured":"Cancer tomorrow. https:\/\/gco.iarc.who.int\/today\/. Accessed 2025 August 29."},{"key":"pone.0352110.ref004","unstructured":"Gbd results. https:\/\/vizhub.healthdata.org\/gbd-results. Accessed 2025 August 29."},{"issue":"10","key":"pone.0352110.ref005","doi-asserted-by":"crossref","first-page":"101174","DOI":"10.1016\/j.tranon.2021.101174","article-title":"Global colorectal cancer burden in 2020 and projections to 2040","volume":"14","author":"Y Xi","year":"2021","journal-title":"Transl Oncol"},{"issue":"05","key":"pone.0352110.ref006","first-page":"393","article-title":"Interpretation of the 2022 global cancer statistics report","volume":"31","author":"Z Zhang","year":"2024","journal-title":"Chinese Hospital Statistics"},{"key":"pone.0352110.ref007","author":"W Chen","year":"2009"},{"key":"pone.0352110.ref008","author":"W Chen","year":"2010"},{"key":"pone.0352110.ref009","author":"W Chen","year":"2011"},{"key":"pone.0352110.ref010","author":"W Chen","year":"2012"},{"key":"pone.0352110.ref011","author":"W Chen","year":"2013"},{"key":"pone.0352110.ref012","author":"W Chen","year":"2014"},{"key":"pone.0352110.ref013","author":"W Chen","year":"2015"},{"key":"pone.0352110.ref014","author":"W Chen","year":"2016"},{"key":"pone.0352110.ref015","first-page":"2017","volume-title":"China cancer registry annual report","author":"W Chen","year":"2016"},{"key":"pone.0352110.ref016","author":"W Chen","year":"2018"},{"key":"pone.0352110.ref017","author":"J He","year":"2019"},{"key":"pone.0352110.ref018","author":"W Wei","year":"2020"},{"key":"pone.0352110.ref019","author":"W Wei","year":"2021"},{"key":"pone.0352110.ref020","first-page":"2022","author":"W Wenqiang"},{"key":"pone.0352110.ref021","unstructured":"National Bureau of Statistics. Census data. https:\/\/www.stats.gov.cn\/sj\/pcsj\/"},{"issue":"7","key":"pone.0352110.ref022","doi-asserted-by":"crossref","first-page":"554","DOI":"10.7326\/M15-1933","article-title":"Health Policy Basics: Implementation of the International Classification of Disease, 10th Revision","volume":"163","author":"B Outland","year":"2015","journal-title":"Ann Intern Med"},{"issue":"7","key":"pone.0352110.ref023","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1002\/(SICI)1097-0258(19970415)16:7<791::AID-SIM500>3.0.CO;2-#","article-title":"Confidence intervals for directly standardized rates: a method based on the gamma distribution","volume":"16","author":"MP Fay","year":"1997","journal-title":"Stat Med"},{"issue":"1","key":"pone.0352110.ref024","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1186\/s12889-023-16226-1","article-title":"Epidemiological characteristics of leukemia in China, 2005-2017: a log-linear regression and age-period-cohort analysis","volume":"23","author":"K Lin","year":"2023","journal-title":"BMC Public Health"},{"key":"pone.0352110.ref025","doi-asserted-by":"crossref","first-page":"1297405","DOI":"10.3389\/fonc.2024.1297405","article-title":"The trend of lymphoma incidence in China from 2005 to 2017 and lymphoma incidence trend prediction from 2018 to 2035: a log-linear regression and Bayesian age-period-cohort analysis","volume":"14","author":"K Lin","year":"2024","journal-title":"Front Oncol"},{"key":"pone.0352110.ref026","author":"X Liu","year":"2022"},{"issue":"7","key":"pone.0352110.ref027","first-page":"648","article-title":"Introduction to age period queue prediction model based on Bayesian method","volume":"46","author":"R Zheng","year":"2012","journal-title":"Chinese Journal of Preventive Medicine"},{"issue":"1","key":"pone.0352110.ref028","doi-asserted-by":"crossref","first-page":"3407","DOI":"10.1186\/s12889-024-20622-6","article-title":"Burden of chronic obstructive pulmonary disease attributable to non-optimal temperature, 1990-2044: six countries on the same isotherm","volume":"24","author":"Z Shi","year":"2024","journal-title":"BMC Public Health"},{"key":"pone.0352110.ref029","unstructured":"Github - timcdlucas\/inlautils: R package providing utilities for inla. https:\/\/github.com\/timcdlucas\/INLAutils. Accessed 2025 November 7."},{"key":"pone.0352110.ref030","unstructured":"Bayesian age-period-cohort model. https:\/\/github.com\/uniwander\/BayesianAgePeriodCohort. 2025."},{"issue":"7","key":"pone.0352110.ref031","article-title":"New approaches for calculating Moran\u2019s index of spatial autocorrelation","volume":"8","author":"Y Chen","year":"2013","journal-title":"PLoS One"},{"key":"pone.0352110.ref032","unstructured":"National Cancer Prevention and Control Platform. https:\/\/www.chinancpcn.org.cn\/home. Accessed 2025 November 19."},{"issue":"6","key":"pone.0352110.ref033","first-page":"1207","article-title":"Meta-analyses of colorectal cancer risk factors","volume":"24","author":"CM Johnson","year":"2013","journal-title":"Cancer Causes Control"},{"key":"pone.0352110.ref034","unstructured":"Over the last six decades, China has rapidly increased and diversified its meat consumption. https:\/\/ourworldindata.org\/data-insights\/over-the-last-six-decades-china-has-rapidly-increased-and-diversified-its-meat-consumption. Accessed 2026 March 24."},{"issue":"8","key":"pone.0352110.ref035","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.numecd.2014.03.002","article-title":"Fatty and lean red meat consumption in China: differential association with Chinese abdominal obesity","volume":"24","author":"Z Wang","year":"2014","journal-title":"Nutr Metab Cardiovasc Dis"},{"issue":"6","key":"pone.0352110.ref036","doi-asserted-by":"crossref","first-page":"399","DOI":"10.26599\/1671-5411.2023.06.001","article-title":"Report on cardiovascular health and diseases in China 2021: an updated summary","volume":"20","author":"TWCOTROCHAD In China","year":"2023","journal-title":"J Geriatr Cardiol"},{"issue":"15","key":"pone.0352110.ref037","doi-asserted-by":"crossref","first-page":"322","DOI":"10.46234\/ccdcw2022.077","article-title":"Colorectal cancer screening in china: status, challenges, and prospects - china, 2022","volume":"4","author":"H Chen","year":"2022","journal-title":"China Cdc Wkly"},{"key":"pone.0352110.ref038","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.3389\/fonc.2020.01173","article-title":"Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China","volume":"10","author":"J Zhang","year":"2020","journal-title":"Front Oncol"},{"issue":"1","key":"pone.0352110.ref039","doi-asserted-by":"crossref","first-page":"10424","DOI":"10.1038\/s41598-019-46670-2","article-title":"Mass screening for colorectal cancer in a population of two million older adults in Guangzhou, China","volume":"9","author":"G Lin","year":"2019","journal-title":"Sci Rep"},{"issue":"7","key":"pone.0352110.ref040","article-title":"Awareness, attitude and barriers of colorectal cancer screening among high-risk populations in China: a cross-sectional study","volume":"11","author":"R-L Huang","year":"2021","journal-title":"BMJ Open"},{"key":"pone.0352110.ref041","doi-asserted-by":"crossref","first-page":"104728","DOI":"10.1016\/j.ijnurstu.2024.104728","article-title":"Uptake and detection rate of colorectal cancer screening with colonoscopy in China: A population-based, prospective cohort study","volume":"153","author":"Z Yu","year":"2024","journal-title":"Int J Nurs Stud"},{"issue":"1","key":"pone.0352110.ref042","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1186\/s12885-025-14589-9","article-title":"Assessing factors influencing participation in LDCT lung cancer screening among high-risk urban populations in Nanjing, China","volume":"25","author":"M Liu","year":"2025","journal-title":"BMC Cancer"},{"issue":"9","key":"pone.0352110.ref043","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1007\/s10654-021-00741-9","article-title":"Consumption of red meat and processed meat and cancer incidence: a systematic review and meta-analysis of prospective studies","volume":"36","author":"MS Farvid","year":"2021","journal-title":"Eur J Epidemiol"},{"issue":"5","key":"pone.0352110.ref044","article-title":"Contributing factors to colorectal cancer screening among Chinese people: a review of quantitative studies","volume":"13","author":"DYP Leung","year":"2016","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0352110.ref045","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1186\/s12889-023-16564-0","article-title":"Performance of different colorectal cancer screening strategies: a long-term passive follow-up population-based screening program in Beijing, China","volume":"23","author":"X Zhang","year":"2023","journal-title":"BMC Public Health"},{"issue":"4","key":"pone.0352110.ref046","doi-asserted-by":"crossref","DOI":"10.1093\/oncolo\/oyad347","article-title":"Rural-urban disparities in colorectal cancer screening, diagnosis, treatment, and survivorship care: a systematic review and meta-analysis","volume":"29","author":"A Sepassi","year":"2024","journal-title":"Oncologist"},{"issue":"11","key":"pone.0352110.ref047","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1002\/cac2.12093","article-title":"Germline mutational profile of Chinese patients under 70 years old with colorectal cancer","volume":"40","author":"T-J Jiang","year":"2020","journal-title":"Cancer Commun (Lond)"},{"issue":"1","key":"pone.0352110.ref048","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1186\/s12876-025-04184-4","article-title":"Global, regional, and national burden of colorectal cancer in the elderly (aged\u2009>\u200960 years): a comprehensive analysis across 204 countries and territories (1990-2021)","volume":"25","author":"S Luo","year":"2025","journal-title":"BMC Gastroenterol"},{"issue":"8","key":"pone.0352110.ref049","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.jacc.2016.06.011","article-title":"Potential Impact of Time Trend of Life-Style Factors on Cardiovascular Disease Burden in China","volume":"68","author":"Y Li","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"pone.0352110.ref050","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1136\/jech-2016-207805","article-title":"Prevalence and patterns of tobacco smoking among Chinese adult men and women: findings of the 2010 national smoking survey","volume":"71","author":"S Liu","year":"2017","journal-title":"J Epidemiol Community Health"},{"issue":"10481","key":"pone.0352110.ref051","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0140-6736(25)00355-1","article-title":"Global, regional, and national prevalence of adult overweight and obesity, 1990-2021, with forecasts to 2050: a forecasting study for the global burden of disease study 2021","volume":"405","year":"2025","journal-title":"Lancet"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0352110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:43:56Z","timestamp":1783014236000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0352110"}},"subtitle":[],"editor":[{"given":"Ana Paula","family":"Drummond Lage","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,2]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0352110","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]}}}