Tomi Akinyemiju

Overview:

Area of Expertise: Epidemiology

Dr. Akinyemiju is a social and molecular cancer epidemiologist with expertise in epidemiologic methods, translational research, health disparities and global health.  Her research interests focus on identifying the impact of social (such as access to healthcare) and biological factors (such as metabolic dysregulation), on cancer related risk, tumor aggressiveness and survival. She has a specific interest in understanding the causes of cancer disparities among women of African descent in the US and sub-Saharan Africa, given their significantly higher risk of aggressive cancer subtypes relative to other racial groups. To achieve these research aims, she utilizes data from population-based cancer registries, administrative claims, and existing cohort studies. Dr. Akinyemiju also leads several primary epidemiologic research studies. She is the PI of a case-control study of newly diagnosed breast cancer patients and healthy women in Nigeria designed to elucidate the impact of metabolic dysregulation, highly prevalent due to the epidemiologic transition, on hormone-receptor negative breast cancer subtypes and associated epigenetic mechanisms. In addition, Dr. Akinyemiju leads an R01 study designed to characterize racial differences across multiple healthcare access dimensions among US ovarian cancer patients, and evaluate the impact of differential healthcare on quality of initial and supportive treatment, and quality of life. A parallel line of research focuses on identifying lifestyle intervention strategies to improve metabolic health among breast cancer patients as a mortality prevention strategy. Dr. Akinyemiju is also passionate about promoting inclusion and diversity in research, teaching and service, and serves as the Director for Inclusion and Diversity at the Duke University Department of Population Health Sciences. 

Positions:

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Associate Research Professor of Global Health

Duke Global Health Institute
Institutes and Provost's Academic Units

Instructor in the Department of Obstetrics and Gynecology

Obstetrics and Gynecology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2012

University of Michigan at Ann Arbor

Grants:

Metabolic Syndrome and Epigenetic Markers of Breast Cancer in Nigerian Women

Administered By
Duke Global Health Institute
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

Publications:

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study.

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
Authors
Global Burden of Disease Cancer Collaboration,; Fitzmaurice, C; Abate, D; Abbasi, N; Abbastabar, H; Abd-Allah, F; Abdel-Rahman, O; Abdelalim, A; Abdoli, A; Abdollahpour, I; Abdulle, ASM; Abebe, ND; Abraha, HN; Abu-Raddad, LJ; Abualhasan, A; Adedeji, IA; Advani, SM; Afarideh, M; Afshari, M; Aghaali, M; Agius, D; Agrawal, S; Ahmadi, A; Ahmadian, E; Ahmadpour, E; Ahmed, MB; Akbari, ME; Akinyemiju, T; Al-Aly, Z; AlAbdulKader, AM; Alahdab, F; Alam, T; Alamene, GM; Alemnew, BTT; Alene, KA; Alinia, C; Alipour, V; Aljunid, SM; Bakeshei, FA; Almadi, MAH; Almasi-Hashiani, A; Alsharif, U; Alsowaidi, S; Alvis-Guzman, N; Amini, E; Amini, S; Amoako, YA; Anbari, Z; Anber, NH; Andrei, CL; Anjomshoa, M; Ansari, F; Ansariadi, A; Appiah, SCY; Arab-Zozani, M; Arabloo, J; Arefi, Z; Aremu, O; Areri, HA; Artaman, A; Asayesh, H; Asfaw, ET; Ashagre, AF; Assadi, R; Ataeinia, B; Atalay, HT; Ataro, Z; Atique, S; Ausloos, M; Avila-Burgos, L; Avokpaho, EFGA; Awasthi, A; Awoke, N; Ayala Quintanilla, BP; Ayanore, MA; Ayele, HT; Babaee, E; Bacha, U; Badawi, A; Bagherzadeh, M; Bagli, E; Balakrishnan, S; Balouchi, A; Bärnighausen, TW; Battista, RJ; Behzadifar, M; Behzadifar, M; Bekele, BB; Belay, YB; Belayneh, YM; Berfield, KKS; Berhane, A; Bernabe, E; Beuran, M; Bhakta, N; Bhattacharyya, K; Biadgo, B; Bijani, A; Bin Sayeed, MS; Birungi, C; Bisignano, C; Bitew, H; Bjørge, T; Bleyer, A; Bogale, KA; Bojia, HA; Borzì, AM; Bosetti, C; Bou-Orm, IR; Brenner, H; Brewer, JD; Briko, AN; Briko, NI; Bustamante-Teixeira, MT; Butt, ZA; Carreras, G; Carrero, JJ; Carvalho, F; Castro, C; Castro, F; Catalá-López, F; Cerin, E; Chaiah, Y; Chanie, WF; Chattu, VK; Chaturvedi, P; Chauhan, NS; Chehrazi, M; Chiang, PP-C; Chichiabellu, TY; Chido-Amajuoyi, OG; Chimed-Ochir, O; Choi, J-YJ; Christopher, DJ; Chu, D-T; Constantin, M-M; Costa, VM; Crocetti, E; Crowe, CS; Curado, MP; Dahlawi, SMA; Damiani, G; Darwish, AH; Daryani, A; das Neves, J; Demeke, FM; Demis, AB; Demissie, BW; Demoz, GT; Denova-Gutiérrez, E; Derakhshani, A; Deribe, KS; Desai, R; Desalegn, BB; Desta, M; Dey, S; Dharmaratne, SD; Dhimal, M; Diaz, D; Dinberu, MTT; Djalalinia, S; Doku, DT; Drake, TM; Dubey, M; Dubljanin, E; Duken, EE; Ebrahimi, H; Effiong, A; Eftekhari, A; El Sayed, I; Zaki, MES; El-Jaafary, SI; El-Khatib, Z; Elemineh, DA; Elkout, H; Ellenbogen, RG; Elsharkawy, A; Emamian, MH; Endalew, DA; Endries, AY; Eshrati, B; Fadhil, I; Fallah, V; Faramarzi, M; Farhangi, MA; Farioli, A; Farzadfar, F; Fentahun, N; Fernandes, E; Feyissa, GT; Filip, I; Fischer, F; Fisher, JL; Force, LM; Foroutan, M; Freitas, M; Fukumoto, T; Futran, ND; Gallus, S; Gankpe, FG; Gayesa, RT; Gebrehiwot, TT; Gebremeskel, GG; Gedefaw, GA; Gelaw, BK; Geta, B; Getachew, S; Gezae, KE; Ghafourifard, M; Ghajar, A; Ghashghaee, A; Gholamian, A; Gill, PS; Ginindza, TTG; Girmay, A; Gizaw, M; Gomez, RS; Gopalani, SV; Gorini, G; Goulart, BNG; Grada, A; Ribeiro Guerra, M; Guimaraes, ALS; Gupta, PC; Gupta, R; Hadkhale, K; Haj-Mirzaian, A; Haj-Mirzaian, A; Hamadeh, RR; Hamidi, S; Hanfore, LK; Haro, JM; Hasankhani, M; Hasanzadeh, A; Hassen, HY; Hay, RJ; Hay, SI; Henok, A; Henry, NJ; Herteliu, C; Hidru, HD; Hoang, CL; Hole, MK; Hoogar, P; Horita, N; Hosgood, HD; Hosseini, M; Hosseinzadeh, M; Hostiuc, M; Hostiuc, S; Househ, M; Hussen, MM; Ileanu, B; Ilic, MD; Innos, K; Irvani, SSN; Iseh, KR; Islam, SMS; Islami, F; Jafari Balalami, N; Jafarinia, M; Jahangiry, L; Jahani, MA; Jahanmehr, N; Jakovljevic, M; James, SL; Javanbakht, M; Jayaraman, S; Jee, SH; Jenabi, E; Jha, RP; Jonas, JB; Jonnagaddala, J; Joo, T; Jungari, SB; Jürisson, M; Kabir, A; Kamangar, F; Karch, A; Karimi, N; Karimian, A; Kasaeian, A; Kasahun, GG; Kassa, B; Kassa, TD; Kassaw, MW; Kaul, A; Keiyoro, PN; Kelbore, AG; Kerbo, AA; Khader, YS; Khalilarjmandi, M; Khan, EA; Khan, G; Khang, Y-H; Khatab, K; Khater, A; Khayamzadeh, M; Khazaee-Pool, M; Khazaei, S; Khoja, AT; Khosravi, MH; Khubchandani, J; Kianipour, N; Kim, D; Kim, YJ; Kisa, A; Kisa, S; Kissimova-Skarbek, K; Komaki, H; Koyanagi, A; Krohn, KJ; Bicer, BK; Kugbey, N; Kumar, V; Kuupiel, D; La Vecchia, C; Lad, DP; Lake, EA; Lakew, AM; Lal, DK; Lami, FH; Lan, Q; Lasrado, S; Lauriola, P; Lazarus, JV; Leigh, J; Leshargie, CT; Liao, Y; Limenih, MA; Listl, S; Lopez, AD; Lopukhov, PD; Lunevicius, R; Madadin, M; Magdeldin, S; El Razek, HMA; Majeed, A; Maleki, A; Malekzadeh, R; Manafi, A; Manafi, N; Manamo, WA; Mansourian, M; Mansournia, MA; Mantovani, LG; Maroufizadeh, S; Martini, SMS; Mashamba-Thompson, TP; Massenburg, BB; Maswabi, MT; Mathur, MR; McAlinden, C; McKee, M; Meheretu, HAA; Mehrotra, R; Mehta, V; Meier, T; Melaku, YA; Meles, GG; Meles, HG; Melese, A; Melku, M; Memiah, PTN; Mendoza, W; Menezes, RG; Merat, S; Meretoja, TJ; Mestrovic, T; Miazgowski, B; Miazgowski, T; Mihretie, KMM; Miller, TR; Mills, EJ; Mir, SM; Mirzaei, H; Mirzaei, HR; Mishra, R; Moazen, B; Mohammad, DK; Mohammad, KA; Mohammad, Y; Darwesh, AM; Mohammadbeigi, A; Mohammadi, H; Mohammadi, M; Mohammadian, M; Mohammadian-Hafshejani, A; Mohammadoo-Khorasani, M; Mohammadpourhodki, R; Mohammed, AS; Mohammed, JA; Mohammed, S; Mohebi, F; Mokdad, AH; Monasta, L; Moodley, Y; Moosazadeh, M; Moossavi, M; Moradi, G; Moradi-Joo, M; Moradi-Lakeh, M; Moradpour, F; Morawska, L; Morgado-da-Costa, J; Morisaki, N; Morrison, SD; Mosapour, A; Mousavi, SM; Muche, AA; Muhammed, OSS; Musa, J; Nabhan, AR; Naderi, M; Nagarajan, AJ; Nagel, G; Nahvijou, A; Naik, G; Najafi, F; Naldi, L; Nam, HS; Nasiri, N; Nazari, J; Negoi, I; Neupane, S; Newcomb, PA; Nggada, HA; Ngunjiri, JW; Nguyen, CT; Nikniaz, L; Ningrum, DNA; Nirayo, YL; Nixon, MR; Nnaji, CA; Nojomi, M; Nosratnejad, S; Shiadeh, MN; Obsa, MS; Ofori-Asenso, R; Ogbo, FA; Oh, I-H; Olagunju, AT; Olagunju, TO; Oluwasanu, MM; Omonisi, AE; Onwujekwe, OE; Oommen, AM; Oren, E; Ortega-Altamirano, DDV; Ota, E; Otstavnov, SS; Owolabi, MO; P A, M; Padubidri, JR; Pakhale, S; Pakpour, AH; Pana, A; Park, E-K; Parsian, H; Pashaei, T; Patel, S; Patil, ST; Pennini, A; Pereira, DM; Piccinelli, C; Pillay, JD; Pirestani, M; Pishgar, F; Postma, MJ; Pourjafar, H; Pourmalek, F; Pourshams, A; Prakash, S; Prasad, N; Qorbani, M; Rabiee, M; Rabiee, N; Radfar, A; Rafiei, A; Rahim, F; Rahimi, M; Rahman, MA; Rajati, F; Rana, SM; Raoofi, S; Rath, GK; Rawaf, DL; Rawaf, S; Reiner, RC; Renzaho, AMN; Rezaei, N; Rezapour, A; Ribeiro, AI; Ribeiro, D; Ronfani, L; Roro, EM; Roshandel, G; Rostami, A; Saad, RS; Sabbagh, P et al.
URI
https://scholars.duke.edu/individual/pub1414985
PMID
31560378
Source
pubmed
Published In
Jama Oncol
Published Date
DOI
10.1001/jamaoncol.2019.2996

Association of baseline inflammatory biomarkers with cancer mortality in the REGARDS cohort.

This study examines the association between inflammatory biomarkers and risk of cancer mortality by race. Data were obtained from 1,856 participants in the prospective REGARDS cohort who were cancer-free at baseline, and analyzed in relation to cancer mortality prospectively. Biomarkers were log-transformed and categorized into tertiles due to non-normal distributions, and Cox proportional hazard regression models were utilized to compute hazard ratios with 95% confidence intervals using robust sandwich methods. Individuals in the highest tertile of IL-6 had over a 12-fold increased risk of cancer mortality (HR: 12.97, 95% CI: 3.46-48.63); those in the highest tertile of IL-8 had over a 2-fold increased risk of cancer mortality (HR: 2.21, 95% CI: 0.86-5.71), while those in the highest tertile of IL-10 had over a 3-fold increased risk of cancer mortality (HR: 3.06, 95% CI: 1.35-6.89). In race-stratified analysis, each unit increase in IL-6 was associated with increased risk of cancer mortality among African-Americans (HR: 3.88, 95% CI: 1.17-12.88) and Whites (5.25, 95% CI: 1.24-22.31). If replicated in larger, racially diverse prospective cohorts, these results suggest that cancer patients may benefit from clinical or lifestyle approaches to regulate systemic inflammation as a cancer prevention strategy.
Authors
Akinyemiju, T; Moore, JX; Pisu, M; Goodman, M; Howard, VJ; Safford, M; Gilchrist, SC; Cushman, M; Long, L; Judd, SE
MLA Citation
Akinyemiju, Tomi, et al. “Association of baseline inflammatory biomarkers with cancer mortality in the REGARDS cohort..” Oncotarget, vol. 10, no. 47, Aug. 2019, pp. 4857–67. Pubmed, doi:10.18632/oncotarget.27108.
URI
https://scholars.duke.edu/individual/pub1406643
PMID
31448052
Source
pubmed
Published In
Oncotarget
Volume
10
Published Date
Start Page
4857
End Page
4867
DOI
10.18632/oncotarget.27108

Hospitalization outcomes and racial disparities in cervical cancer patients: An analysis of the national inpatient sample data from 2002 to 2014.

BACKGROUND: Little is known about outcomes in patients after being hospitalized for care of cancer or comorbid conditions and the disparity between African-American and White cervical cancer patients. METHODS: Using the national inpatient sample (HCUP-NIS) database of the Healthcare Cost and Utilization Project between 2002-2014, we included 5217 African-American and 21,752 White patients hospitalized with a primary diagnosis of cervical cancer. We examined racial differences in hospitalization outcomes; length of stay (LOS) in hospital, mortality in hospital, post-operative complications in patients who underwent hysterectomy and discharge disposition. Patients were matched on age at primary diagnosis, insurance status, residential region, and median income of residential area, modified Deyo comorbidity index, stage of disease and treatment. Categorical outcomes were analyzed by conditional logistic regression accounting for matched study design and odds ratios (95%CI) were reported. LOS was analyzed using t-test and beta estimate for difference in means was reported. RESULTS: The LOS was significantly lower for Whites compared to African-American cervical cancer patients when matched on demographic only (β=-0.41, p-value<0.0005, presentation + demographic (β=-0.41, p-value<0.0006) and treatment + presentation + demographic variables (β=-0.46, p-value<0.0001). White cervical cancer patients were commonly discharged to other intermediate nursing facility (OR = 1.30, 95%CI = 1.20-1.41, matched on demographic only; OR = 1.31, 95%CI = 1.21-1.43, matched on presentation + demographic; and OR = 1.32, 95%CI = 1.22-1.43), matched on treatment + presentation + demographic). Similar trends were seen in both older (≥65 years) and younger (<65 years) patients, when stratified by age. CONCLUSION: Disparities in hospitalization outcomes in cervical patients are not observed when different characteristics of African-American and White cervical patients are accounted for and matched.
Authors
Naik, G; Mukherjee, A; Akinyemiju, T; Shrestha, S
MLA Citation
Naik, Gurudatta, et al. “Hospitalization outcomes and racial disparities in cervical cancer patients: An analysis of the national inpatient sample data from 2002 to 2014..” Cancer Epidemiol, vol. 63, Dec. 2019. Pubmed, doi:10.1016/j.canep.2019.101620.
URI
https://scholars.duke.edu/individual/pub1416441
PMID
31634776
Source
pubmed
Published In
Cancer Epidemiol
Volume
63
Published Date
Start Page
101620
DOI
10.1016/j.canep.2019.101620

The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Worldwide, both the incidence and death rates of pancreatic cancer are increasing. Evaluation of pancreatic cancer burden and its global, regional, and national patterns is crucial to policy making and better resource allocation for controlling pancreatic cancer risk factors, developing early detection methods, and providing faster and more effective treatments. METHODS: Vital registration, vital registration sample, and cancer registry data were used to generate mortality, incidence, and disability-adjusted life-years (DALYs) estimates. We used the comparative risk assessment framework to estimate the proportion of deaths attributable to risk factors for pancreatic cancer: smoking, high fasting plasma glucose, and high body-mass index. All of the estimates were reported as counts and age-standardised rates per 100 000 person-years. 95% uncertainty intervals (UIs) were reported for all estimates. FINDINGS: In 2017, there were 448 000 (95% UI 439 000-456 000) incident cases of pancreatic cancer globally, of which 232 000 (210 000-221 000; 51·9%) were in males. The age-standardised incidence rate was 5·0 (4·9-5·1) per 100 000 person-years in 1990 and increased to 5·7 (5·6-5·8) per 100 000 person-years in 2017. There was a 2·3 times increase in number of deaths for both sexes from 196 000 (193 000-200 000) in 1990 to 441 000 (433 000-449 000) in 2017. There was a 2·1 times increase in DALYs due to pancreatic cancer, increasing from 4·4 million (4·3-4·5) in 1990 to 9·1 million (8·9-9·3) in 2017. The age-standardised death rate of pancreatic cancer was highest in the high-income super-region across all years from 1990 to 2017. In 2017, the highest age-standardised death rates were observed in Greenland (17·4 [15·8-19·0] per 100 000 person-years) and Uruguay (12·1 [10·9-13·5] per 100 000 person-years). These countries also had the highest age-standardised death rates in 1990. Bangladesh (1·9 [1·5-2·3] per 100 000 person-years) had the lowest rate in 2017, and São Tomé and Príncipe (1·3 [1·1-1·5] per 100 000 person-years) had the lowest rate in 1990. The numbers of incident cases and deaths peaked at the ages of 65-69 years for males and at 75-79 years for females. Age-standardised pancreatic cancer deaths worldwide were primarily attributable to smoking (21·1% [18·8-23·7]), high fasting plasma glucose (8·9% [2·1-19·4]), and high body-mass index (6·2% [2·5-11·4]) in 2017. INTERPRETATION: Globally, the number of deaths, incident cases, and DALYs caused by pancreatic cancer has more than doubled from 1990 to 2017. The increase in incidence of pancreatic cancer is likely to continue as the population ages. Prevention strategies should focus on modifiable risk factors. Development of screening programmes for early detection and more effective treatment strategies for pancreatic cancer are needed. FUNDING: Bill & Melinda Gates Foundation.
Authors
GBD 2017 Pancreatic Cancer Collaborators,
MLA Citation
GBD 2017 Pancreatic Cancer Collaborators, F. “The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017..” Lancet Gastroenterol Hepatol, vol. 4, no. 12, Dec. 2019, pp. 934–47. Pubmed, doi:10.1016/S2468-1253(19)30347-4.
URI
https://scholars.duke.edu/individual/pub1418744
PMID
31648972
Source
pubmed
Published In
The Lancet. Gastroenterology & Hepatology
Volume
4
Published Date
Start Page
934
End Page
947
DOI
10.1016/S2468-1253(19)30347-4

The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

BACKGROUND: Data about the global, regional, and country-specific variations in the levels and trends of colorectal cancer are required to understand the impact of this disease and the trends in its burden to help policy makers allocate resources. Here we provide a status report on the incidence, mortality, and disability caused by colorectal cancer in 195 countries and territories between 1990 and 2017. METHODS: Vital registration, sample vital registration, verbal autopsy, and cancer registry data were used to generate incidence, death, and disability-adjusted life-year (DALY) estimates of colorectal cancer at the global, regional, and national levels. We also determined the association between development levels and colorectal cancer age-standardised DALY rates, and calculated DALYs attributable to risk factors that had evidence of causation with colorectal cancer. All of the estimates are reported as counts and age-standardised rates per 100 000 person-years, with some estimates also presented by sex and 5-year age groups. FINDINGS: In 2017, there were 1·8 million (95% UI 1·8-1·9) incident cases of colorectal cancer globally, with an age-standardised incidence rate of 23·2 (22·7-23·7) per 100 000 person-years that increased by 9·5% (4·5-13·5) between 1990 and 2017. Globally, colorectal cancer accounted for 896 000 (876 300-915 700) deaths in 2017, with an age-standardised death rate of 11·5 (11·3-11·8) per 100 000 person-years, which decreased between 1990 and 2017 (-13·5% [-18·4 to -10·0]). Colorectal cancer was also responsible for 19·0 million (18·5-19·5) DALYs globally in 2017, with an age-standardised rate of 235·7 (229·7-242·0) DALYs per 100 000 person-years, which decreased between 1990 and 2017 (-14·5% [-20·4 to -10·3]). Slovakia, the Netherlands, and New Zealand had the highest age-standardised incidence rates in 2017. Greenland, Hungary, and Slovakia had the highest age-standardised death rates in 2017. Numbers of incident cases and deaths were higher among males than females up to the ages of 80-84 years, with the highest rates observed in the oldest age group (≥95 years) for both sexes in 2017. There was a non-linear association between the Socio-demographic Index and the Healthcare Access and Quality Index and age-standardised DALY rates. In 2017, the three largest contributors to DALYs at the global level, for both sexes, were diet low in calcium (20·5% [12·9-28·9]), alcohol use (15·2% [12·1-18·3]), and diet low in milk (14·3% [5·1-24·8]). INTERPRETATION: There is substantial global variation in the burden of colorectal cancer. Although the overall colorectal cancer age-standardised death rate has been decreasing at the global level, the increasing age-standardised incidence rate in most countries poses a major public health challenge across the world. The results of this study could be useful for policy makers to carry out cost-effective interventions and to reduce exposure to modifiable risk factors, particularly in countries with high incidence or increasing burden. FUNDING: Bill & Melinda Gates Foundation.
Authors
GBD 2017 Colorectal Cancer Collaborators,
MLA Citation
GBD 2017 Colorectal Cancer Collaborators, Mohsen. “The global, regional, and national burden of colorectal cancer and its attributable risk factors in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017..” Lancet Gastroenterol Hepatol, vol. 4, no. 12, Dec. 2019, pp. 913–33. Pubmed, doi:10.1016/S2468-1253(19)30345-0.
URI
https://scholars.duke.edu/individual/pub1418745
PMID
31648977
Source
pubmed
Published In
The Lancet. Gastroenterology & Hepatology
Volume
4
Published Date
Start Page
913
End Page
933
DOI
10.1016/S2468-1253(19)30345-0

Research Areas:

Cancer
Epidemiology
Epigenetics
Global health
Health Disparities
Molecular Epidemiology
Social Determinants of Health