Burden of colorectal cancer attributable to diet low in milk in China, 1990–2017: findings from the global burden of disease study 2017

• Published in: Journal of human nutrition and dietetics 2021-02, Vol.34 (1), p.233-242
• Main Authors: Wang, Z.Q., Zhang, L., Guo, W.B., Gao, Y., Li, X.J., Zhao, Y.F., Liu, J.M., Zhou, M.G., Li, M.
• Format: Article
• Language: English
• Subjects: Age; Cancer; China; Colorectal cancer; Colorectal carcinoma; Diet; diet low in milk; disability‐adjusted life‐years; Fatalities; Geographical variations; Global Burden of Disease Study; Males; Mathematical analysis; Milk; Mortality; Nutrient deficiency; Older people; Public health; Risk analysis; Risk factors; Trends
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/jhn.12836

Background Colorectal cancer (CRC) has emerged as a major public health concern. However, little is known about the burden attributable to specific risk factors. The present study aimed to estimate the temporal trends and geographical variation of CRC burden attributable to a diet low in milk in China. Methods Following the general analytic strategy used in the 2017 Global Burden of Disease study, we assessed the age‐, sex‐, and province‐specific mortality and disability‐adjusted life‐years (DALYs) of CRC caused by a diet low in milk in China from 1990 to 2017. Results In 2017, a diet low in milk contributed 32 032 [95% uncertainty interval (UI) = 11 350–53 806] deaths and 726 710 (95% UI = 256 651–1 218 153) DALYs for CRC with a population attributable fraction of 17.1%. The age‐standardised mortality and DALY rates per 100 000 were 1.7 (95% UI = 0.6–2.9) and 36.8 (95% UI = 13.0–61.7), respectively. An upward trend with age in rates of mortality and DALYs was observed. Males had higher age‐standardised rates than females. The number of deaths and DALYs increased significantly from 1990 to 2017, whereas the corresponding age‐standardised rates showed relatively stable trends. In 2017, Hunan and Liaoning were ranked as the top two provinces in terms of disease burden. Socio‐demographic index had a weak correlation with the age‐standardised mortality (r = 0.348, P = 0.047). Conclusions The present study shows a substantial increase in the CRC burden attributable to a diet low in milk over the past three decades. Greater priority in CRC prevention should be given to males and the elderly population throughout China, particularly in less‐developed provinces. The study present systematically assessed the colorectal cancer (CRC) burden (deaths and disability‐adjusted life‐years) attributable to a diet low in milk in China from 1990 to 2017 by sex, age and geographic alarea. The results will help to identify the current status and trends for the CRC burden and to provide evidence for policy makers to take targeted interventions of prevention and management in the future.