Title: Global, Regional, and National Burden of Colorectal Cancer in the Elderly (Aged >60
Years): A Comprehensive Analysis Across 204 Countries and Territories (1990-2021)
Version: 1 Date: 20 Jun 2025
Reviewer's report:
I commend the authors for their efforts in addressing an important topic and for assembling
a comprehensive dataset and analytical framework. Given the complexity and breadth of the
methodology, I am unable to independently verify the accuracy of the underlying data or
analyses, which may also be beyond the intended scope of this review. However, assuming the
soundness of the data and methodology, I generally support the scope and conclusions presented.
I offer the following minor comments for the authors’ consideration:
1. Clarification on Standard Population Used for Age-Standardization
Age-standardized rates are typically used to facilitate comparisons across populations over time
or between geographic regions. For GLOBOCAN data, the 1966 Segi–Doll World Standard
Population is commonly employed. Based on the appendix, it appears that the authors used
the 2021 Global Burden of Disease (GBD) world population instead. If so, I suggest explicitly
stating the standard population used in the Methods section and providing a rationale for this
choice.
2. Clarification on Hereditary CRC Syndromes in the Discussion
In the Discussion section, the authors state:
“Additionally, the timely diagnosis and treatment of hereditary CRC syndromes, such as Lynch
Syndrome and familial adenomatous polyposis, in high-SDI regions may also contribute to the
declining trend in elderly CRC incidence…”
While early diagnosis and intervention for hereditary CRC syndromes may influence overall
trends, conditions like Lynch Syndrome and FAP are typically diagnosed in younger individuals,
often under the age of 50. Given that the manuscript focuses on individuals aged 60 and older, I
recommend revising or qualifying this statement to better reflect age-related incidence patterns.
3. Potential Typographical Error in Limitations
In the Limitations section, the manuscript states:
“This could result in inaccuracies when estimating the true burden of elderly hip fractures.”
This appears to be unrelated to the main topic of the manuscript and may have been included
inadvertently. If so, please revise or remove for clarity.
4. In Figure 4, some of the letters in the labels appear to be cut off or incomplete. Please revise
the figure to ensure that all text elements are fully visible and legible.
Title: Global, Regional, and National Burden of Colorectal Cancer in the Elderly (Aged >60
Years): A Comprehensive Analysis Across 204 Countries and Territories (1990-2021)
Version: 1 Date: 20 Jun 2025
Reviewer's report:
I commend the authors for their efforts in addressing an important topic and for assembling
a comprehensive dataset and analytical framework. Given the complexity and breadth of the
methodology, I am unable to independently verify the accuracy of the underlying data or
analyses, which may also be beyond the intended scope of this review. However, assuming the
soundness of the data and methodology, I generally support the scope and conclusions presented.
I offer the following minor comments for the authors’ consideration:
1. Clarification on Standard Population Used for Age-Standardization
Age-standardized rates are typically used to facilitate comparisons across populations over time
or between geographic regions. For GLOBOCAN data, the 1966 Segi–Doll World Standard
Population is commonly employed. Based on the appendix, it appears that the authors used
the 2021 Global Burden of Disease (GBD) world population instead. If so, I suggest explicitly
stating the standard population used in the Methods section and providing a rationale for this
choice.
2. Clarification on Hereditary CRC Syndromes in the Discussion
In the Discussion section, the authors state:
“Additionally, the timely diagnosis and treatment of hereditary CRC syndromes, such as Lynch
Syndrome and familial adenomatous polyposis, in high-SDI regions may also contribute to the
declining trend in elderly CRC incidence…”
While early diagnosis and intervention for hereditary CRC syndromes may influence overall
trends, conditions like Lynch Syndrome and FAP are typically diagnosed in younger individuals,
often under the age of 50. Given that the manuscript focuses on individuals aged 60 and older, I
recommend revising or qualifying this statement to better reflect age-related incidence patterns.
3. Potential Typographical Error in Limitations
In the Limitations section, the manuscript states:
“This could result in inaccuracies when estimating the true burden of elderly hip fractures.”
This appears to be unrelated to the main topic of the manuscript and may have been included
inadvertently. If so, please revise or remove for clarity.
4. In Figure 4, some of the letters in the labels appear to be cut off or incomplete. Please revise
the figure to ensure that all text elements are fully visible and legible.
Please review this paper.
user
Title: Global, Regional, and National Burden of Colorectal Cancer in the Elderly (Aged >60
Years): A Comprehensive Analysis Across 204 Countries and Territories (1990-2021)
Version: 1 Date: 20 Jun 2025
Reviewer's report:
I commend the authors for their efforts in addressing an important topic and for assembling
a comprehensive dataset and analytical framework. Given the complexity and breadth of the
methodology, I am unable to independently verify the accuracy of the underlying data or
analyses, which may also be beyond the intended scope of this review. However, assuming the
soundness of the data and methodology, I generally support the scope and conclusions presented.
I offer the following minor comments for the authors’ consideration:
1. Clarification on Standard Population Used for Age-Standardization
Age-standardized rates are typically used to facilitate comparisons across populations over time
or between geographic regions. For GLOBOCAN data, the 1966 Segi–Doll World Standard
Population is commonly employed. Based on the appendix, it appears that the authors used
the 2021 Global Burden of Disease (GBD) world population instead. If so, I suggest explicitly
stating the standard population used in the Methods section and providing a rationale for this
choice.
2. Clarification on Hereditary CRC Syndromes in the Discussion
In the Discussion section, the authors state:
“Additionally, the timely diagnosis and treatment of hereditary CRC syndromes, such as Lynch
Syndrome and familial adenomatous polyposis, in high-SDI regions may also contribute to the
declining trend in elderly CRC incidence…”
While early diagnosis and intervention for hereditary CRC syndromes may influence overall
trends, conditions like Lynch Syndrome and FAP are typically diagnosed in younger individuals,
often under the age of 50. Given that the manuscript focuses on individuals aged 60 and older, I
recommend revising or qualifying this statement to better reflect age-related incidence patterns.
3. Potential Typographical Error in Limitations
In the Limitations section, the manuscript states:
“This could result in inaccuracies when estimating the true burden of elderly hip fractures.”
This appears to be unrelated to the main topic of the manuscript and may have been included
inadvertently. If so, please revise or remove for clarity.
4. In Figure 4, some of the letters in the labels appear to be cut off or incomplete. Please revise
the figure to ensure that all text elements are fully visible and legible.
assistant