Title: Global burden of colon and rectal cancer and attributable risk factors in 204 countries and
territories from 1990 to 2021
Version: 0 Date: 03 Mar 2025
Reviewer's report:
This manuscript leverages the Global Burden of Disease (GBD) 2021 data to conduct a
thorough evaluation of global, regional, and country-specific trends in colon and rectal cancers
(CRCs). The authors report on incidence, prevalence, mortality, and disability-adjusted life
years (DALYs), then delineate how multiple risk factors—such as high red meat consumption,
obesity, and insufficient calcium intake—contribute to CRC burdens across different World
Bank income regions. Notably, the authors observe a decline in the global age-standardized
DALY rate (ASDR) and mortality rate (ASMR) for CRC from 1990 to 2021, although the age-
standardized incidence rate (ASIR) slightly increased. Importantly, there is substantial regional
heterogeneity: high-income regions demonstrate progress in decreasing mortality and DALYs
while still bearing the highest CRC burden. By contrasting these diverse patterns, the manuscript
underscores the role of socioeconomic factors and lifestyle exposures in driving CRC outcomes.
Overall, this manuscript offers compelling analysis and valuable insights for global health
stakeholders. Once the following points are addressed in a revision, it will be well placed for
publication:
Please provide more detailed information on how UIs and CIs were calculated. Indicate the
statistical methodologies, software, or models used to generate these intervals, and outline any
underlying assumptions (e.g., bootstrapping or Monte Carlo simulations).
Some terms, such as “women” versus “female,” appear inconsistently throughout the
manuscript. Incorporate standard language (e.g., “women” or “males”/“females”) and apply it
uniformly to maintain clarity and professionalism.
While the manuscript marks a significant contribution to understanding CRC burdens,
further discussion on the public health implications of the results would be beneficial. This
would include how policymakers might leverage these findings to guide cancer prevention
measures, screening programs, dietary guidelines, and educational campaigns within varying
socioeconomic contexts.
Title: Global burden of colon and rectal cancer and attributable risk factors in 204 countries and
territories from 1990 to 2021
Version: 0 Date: 03 Mar 2025
Reviewer's report:
This manuscript leverages the Global Burden of Disease (GBD) 2021 data to conduct a
thorough evaluation of global, regional, and country-specific trends in colon and rectal cancers
(CRCs). The authors report on incidence, prevalence, mortality, and disability-adjusted life
years (DALYs), then delineate how multiple risk factors—such as high red meat consumption,
obesity, and insufficient calcium intake—contribute to CRC burdens across different World
Bank income regions. Notably, the authors observe a decline in the global age-standardized
DALY rate (ASDR) and mortality rate (ASMR) for CRC from 1990 to 2021, although the age-
standardized incidence rate (ASIR) slightly increased. Importantly, there is substantial regional
heterogeneity: high-income regions demonstrate progress in decreasing mortality and DALYs
while still bearing the highest CRC burden. By contrasting these diverse patterns, the manuscript
underscores the role of socioeconomic factors and lifestyle exposures in driving CRC outcomes.
Overall, this manuscript offers compelling analysis and valuable insights for global health
stakeholders. Once the following points are addressed in a revision, it will be well placed for
publication:
Please provide more detailed information on how UIs and CIs were calculated. Indicate the
statistical methodologies, software, or models used to generate these intervals, and outline any
underlying assumptions (e.g., bootstrapping or Monte Carlo simulations).
Some terms, such as “women” versus “female,” appear inconsistently throughout the
manuscript. Incorporate standard language (e.g., “women” or “males”/“females”) and apply it
uniformly to maintain clarity and professionalism.
While the manuscript marks a significant contribution to understanding CRC burdens,
further discussion on the public health implications of the results would be beneficial. This
would include how policymakers might leverage these findings to guide cancer prevention
measures, screening programs, dietary guidelines, and educational campaigns within varying
socioeconomic contexts.
Please review this paper.
user
Title: Global burden of colon and rectal cancer and attributable risk factors in 204 countries and
territories from 1990 to 2021
Version: 0 Date: 03 Mar 2025
Reviewer's report:
This manuscript leverages the Global Burden of Disease (GBD) 2021 data to conduct a
thorough evaluation of global, regional, and country-specific trends in colon and rectal cancers
(CRCs). The authors report on incidence, prevalence, mortality, and disability-adjusted life
years (DALYs), then delineate how multiple risk factors—such as high red meat consumption,
obesity, and insufficient calcium intake—contribute to CRC burdens across different World
Bank income regions. Notably, the authors observe a decline in the global age-standardized
DALY rate (ASDR) and mortality rate (ASMR) for CRC from 1990 to 2021, although the age-
standardized incidence rate (ASIR) slightly increased. Importantly, there is substantial regional
heterogeneity: high-income regions demonstrate progress in decreasing mortality and DALYs
while still bearing the highest CRC burden. By contrasting these diverse patterns, the manuscript
underscores the role of socioeconomic factors and lifestyle exposures in driving CRC outcomes.
Overall, this manuscript offers compelling analysis and valuable insights for global health
stakeholders. Once the following points are addressed in a revision, it will be well placed for
publication:
Please provide more detailed information on how UIs and CIs were calculated. Indicate the
statistical methodologies, software, or models used to generate these intervals, and outline any
underlying assumptions (e.g., bootstrapping or Monte Carlo simulations).
Some terms, such as “women” versus “female,” appear inconsistently throughout the
manuscript. Incorporate standard language (e.g., “women” or “males”/“females”) and apply it
uniformly to maintain clarity and professionalism.
While the manuscript marks a significant contribution to understanding CRC burdens,
further discussion on the public health implications of the results would be beneficial. This
would include how policymakers might leverage these findings to guide cancer prevention
measures, screening programs, dietary guidelines, and educational campaigns within varying
socioeconomic contexts.
assistant