Abstract: Background and purpose: With the changes in people’s lifestyles and dietary habits, there were upward trends in colorectal cancer mortality. We analyzed epidemiological features, distribution and time trend of colon, rectal and anal cancers in China for the last 30 years. Methods: Mortality data from 1987 to 2015 were aggregated for estimating annual changes in mortality rates. Negative binomial regression model was used to explore population-level risk factors of the cancer death. Results: Decreasing mortality rates among females in urban areas [average annual percent change (AAPC) =-0.59%] and in rural areas (AAPC=-0.45%) were observed, while increasing mortality rate was observed among males (0.50% in urban areas, 0.57% in rural areas). The age-specific mortality rates roughly decreased among males under age 65 and females under age 75, but increased among males over age 65 and females over age 75. The cancer death risks were higher in urban populations than in rural populations (OR=1.46, 95%CI: 1.40-1.52) as well as in males than in females (OR=1.38, 95%CI: 1.32-1.42). Mortality increased by 51% with a 5-year increment (OR=1.50, 95%CI: 1.49-1.51), yet increased by 0.08% with a one-year increment but the difference was not statistically significant (OR=1.00, P=0.47). Conclusion: The trends in colorectal cancer mortality differred by region, gender and age. Colon, rectal and anal cancers mortality decreased among females and young adults, while increased in males and the elderly.

Key words: Colorectal cancer, Mortality, Trends, Risk factors