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Mass Screening / Early Detection of Cancer / Colorectal Neoplasms · Journal article
Annals of Medicine · September 5, 2026
Early or partial results. Treat as a signal, not a conclusion.
This secondary analysis of Global Burden of Disease 2023 data stratifies colorectal cancer burden (incidence, deaths, DALYs) by four age groups (15–44, 45–49, 50–74, 75+ years) to test whether adults aged 45–49 occupy a distinct epidemiologic position around the contemporary screening threshold. The authors report differential age-specific trends in incidence and mortality, narrowing inequality metrics in the 45–49 age group, and screening-detection signals in High-SDI populations post-2018, concluding that this threshold-adjacent cohort warrants distinct surveillance consideration rather than merging with broader younger-than-50 categories.
Secondary analysis of global burden of disease database with age stratification, inequality measurement, and decomposition analysis. Global population aged 15+ years included in GBD 2023 database, stratified by five socio-demographic index quintiles and four age groups. Global; analysis spans data from all countries in GBD 2023.
Incidence rose most steeply in adults aged 15–44 (+16.8%) and 45–49 years (+11.0%), with smaller increases in those aged 50–74 (+7.5%) and 75+ (+3.6%) In adults aged 45–49, incidence inequality narrowed (concentration index 0.304 to 0.253; relative SII 1.693 to 1.412) DALY inequality in adults aged 45–49 weakened (concentration index 0.159 to 0.068)
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The findings are framed by the authors as relevant to population-level surveillance and policy evaluation rather than individual clinical decision-making. Clinicians should note that this descriptive analysis supports distinct epidemiologic characterization of the 45–49 age group around contemporary screening thresholds but does not itself justify changes to individual screening recommendations.
This is a descriptive analysis of global burden data (GBD 2023) examining age-stratified trends in colorectal cancer incidence, mortality, and DALYs; it is observational, lacks a comparator intervention, and generates hypotheses about threshold-adjacent burden redistribution rather than testing a clinical intervention or providing definitive evidence for practice change.
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Quoted from the source exactly as published.
The findings are framed by the authors as relevant to population-level surveillance and policy evaluation rather than individual clinical decision-making. Clinicians should note that this descriptive analysis supports distinct epidemiologic characterization of the 45–49 age group around contemporary screening thresholds but does not itself justify changes to individual screening recommendations.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. Conventional age <50 versus ≥50 years grouping may obscure colorectal cancer (CRC) burden patterns around the contemporary screening boundary. We examined whether adults aged 45-49 years occupy a threshold-adjacent position not captured by conventional grouping.Methods. Using GBD 2023 data, we analyzed CRC incidence, deaths, and DALYs from 1990 to 2023 across four age groups (15-44, 45-49, 50-74, 75+ years). We assessed global and SDI-stratified trends, inequality, empirical lower-bound burden frontiers, and decomposition of burden change. Sensitivity analyses included conventional age regrouping, High versus Non-High SDI decomposition, split-period analyses, and adjacent 5-year age-group comparisons.Results. Incidence rose most in adults aged 15-44 (+16.8%) and 45-49 years (+11.0%), with smaller increases in those aged 50-74 (+7.5%) and 75+ (+3.6%). Deaths and DALYs declined more clearly above age 50. In adults aged 45-49, incidence inequality remained positive but narrowed (CI: 0.304 to 0.253; relative SII: 1.693 to 1.412), while DALY inequality weakened (CI: 0.159 to 0.068). During 2010-2023, the residual rate-change component contributed positively to incidence in adults aged 45-49 globally (31.5%) but was slightly negative in those aged 50-74 (-2.6%). Post-2018 amplification in High-SDI populations was consistent with screening-related detection effects.Conclusions. Adults aged 45-49 occupy a context-dependent threshold-adjacent position in global CRC burden redistribution. These findings inform population-level surveillance and policy evaluation rather than individual-level clinical decision-making.
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