---
title: "Screening-threshold framework shows 45–49-year-olds as threshold-adjacent in global colorectal can"
id: "pubmed-42700379"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42700379"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42700379/"
doi: "10.1080/07853890.2026.2728455"
published_at: "2026-09-05T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Screening-threshold framework shows 45–49-year-olds as threshold-adjacent in global colorectal can
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42700379
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42700379/)
- **DOI:** [10.1080/07853890.2026.2728455](https://doi.org/10.1080%2F07853890.2026.2728455)
- **Published At:** 2026-09-05T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The study used **GBD 2023** data to examine colorectal cancer (CRC) incidence, deaths, and DALYs from 1990 to 2023 across four age groups: **15–44**, **45–49**, **50–74**, and **75+** years. - Authors evaluated global and SDI-stratified trends, inequality measures, 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. - Incidence increases were largest in ages 15–44 (+16.8%) and 45–49 (+11.0%), smaller in 50–74 (+7.5%), and smallest in 75+ (+3.6%). - Deaths and DALYs declined more clearly in age groups older than 50 years. - In the 45–49 group, incidence inequality remained positive but narrowed (concentration index from 0.304 to 0.253; relative SII from 1.693 to 1.412). DALY inequality in this group also weakened (concentration index 0.159 to 0.068). - Decomposition showed the residual rate-change component contributed positively to incidence among 45–49-year-olds globally (31.5%) but was slightly negative for ages 50–74 (-2.6%) during 2010–2023. - Post-2018 amplification of incidence in High-SDI populations was consistent with screening-related detection effects. - Overall, adults aged 45–49 occupy a context-dependent **threshold-adjacent** position in global CRC burden redistribution; findings are intended for population-level surveillance and policy evaluation rather than individual clinical decision-making.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 5. # A screening-threshold-oriented framework reveals threshold-adjacent redistribution of global colorectal cancer burden: an analysis of GBD 2023 [Jiajun Luo](https://pubmed.ncbi.nlm.nih.gov/?term=Luo+J&cauthor_id=42700379)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#full-view-affiliation-1 "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China."), [Xi Song](https://pubmed.ncbi.nlm.nih.gov/?term=Song+X&cauthor_id=42700379)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#full-view-affiliation-2 "Department of Neurobiology, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, China."), [Ziwei Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Z&cauthor_id=42700379)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#full-view-affiliation-1 "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China."), [Xiaolong Liang](https://pubmed.ncbi.nlm.nih.gov/?term=Liang+X&cauthor_id=42700379)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#full-view-affiliation-1 "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.") Affiliations Expand ### Affiliations * 1 Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. * 2 Department of Neurobiology, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, China. * PMID: **42700379** * DOI: [ 10.1080/07853890.2026.2728455 ](https://doi.org/10.1080/07853890.2026.2728455) Item in Clipboard # A screening-threshold-oriented framework reveals threshold-adjacent redistribution of global colorectal cancer burden: an analysis of GBD 2023 Jiajun Luo et al. Ann Med. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Ann Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42700379/) . 2026 Dec;58(1):2728455. doi: 10.1080/07853890.2026.2728455. Epub 2026 Sep 5. ### Authors [Jiajun Luo](https://pubmed.ncbi.nlm.nih.gov/?term=Luo+J&cauthor_id=42700379)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#short-view-affiliation-1 "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China."), [Xi Song](https://pubmed.ncbi.nlm.nih.gov/?term=Song+X&cauthor_id=42700379)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#short-view-affiliation-2 "Department of Neurobiology, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, China."), [Ziwei Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Z&cauthor_id=42700379)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#short-view-affiliation-1 "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China."), [Xiaolong Liang](https://pubmed.ncbi.nlm.nih.gov/?term=Liang+X&cauthor_id=42700379)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42700379/#short-view-affiliation-1 "Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.") ### Affiliations * 1 Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. * 2 Department of Neurobiology, School of Basic Medical Sciences, Chongqing Medical University, Chongqing, China. * PMID: **42700379** * DOI: [ 10.1080/07853890.2026.2728455 ](https://doi.org/10.1080/07853890.2026.2728455) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **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. **Keywords:** Colorectal cancer; DALYs; GBD 2023; SDI; age groups; decomposition; inequality; screening threshold. 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