分析1990~2021年中国结直肠癌死亡率的长期变化趋势，为中国结直肠癌的防控提供科学建议。

从2021年全球疾病负担（GBD2021）数据库获取1990~2021年中国结直肠癌的死亡负担数据，使用年龄-时期-队列模型评估年龄、时期和队列效应。

1990~2021年中国结直肠癌总人群、女性标化死亡率整体呈下降趋势。年龄-时期-队列模型分析显示，1990~2021年中国结直肠癌年龄死亡率随年龄增加呈上升趋势，总人群从0.51/10万增至224.02/10万、男性从0.48/10万增至525.14/10万、女性从0.62/10万增至107.38/10万；时期效应整体呈下降趋势，总人群死亡风险从1992年的1.17降至2021年的0.96、男性死亡风险从1.03降至1.00、女性人群的死亡风险从1.42降至0.89。队列效应均呈下降的趋势。总人群的死亡风险从1897~1904年出生队列组的1.42降至1997~2006年出生队列组的0.48、男性人群的死亡风险从1.03降至0.67、女性人群的死亡风险从2.20降至0.25。在2011~2021年间，死亡风险均呈缓慢上升趋势。

1990~2021年总人群及女性死亡负担下降，男性死亡负担上升，然而，2016~2021年中国不同性别人群的结直肠癌死亡负担均呈缓慢上升趋势，提示死亡负担仍然严峻，应重点加强对中老年男性人群的关注，加强对高危人群进行有效的干预措施，以期减少结直肠癌的死亡负担。

To analyze the long-term change trend of colorectal mortality in China from 1990 to 2021, and to provide scientific recommendations for the prevention and control of colorectal cancer in China.

The mortality burden data of colorectal cancer in China from 1990 to 2021 were obtained from GBD2021. The trend of mortality was analyzed by Joinpoint regression model, Using age-period-queue model assessment age, period and cohort effects.

From 1990 to 2021, the overall colorectal population and the standardized mortality rate of females in China showed a downward trend, while that of males showed an upward trend, and the change rates were -11.94%, 2.10% and -29.40%, respectively. APC model analysis showed that from 1990 to 2021, the colorectal age mortality rate in China increased with the increase of age, from 0.51/100 000 to 224.02/100 000 for the total population, from 0.48/100 000 to 525.14/100 000 for males, and from 0.62/100 000 to 107.38/100 000 for females. The period effect showed an overall downward trend, with the risk of death decreasing from 1.17 in 1992 to 0.96 in 2021 in the general population, from 1.03 to 1.00 in men, and from 1.42 to 0.89 in women. All the cohort effects showed a decreasing trend. The risk of death in the general population decreased from 1.42 in the 1897~1904 birth cohort to 0.48 in the 1997~2006 birth cohort, from 1.03 to 0.67 in men, and from 2.20 to 0.25 in women. It is important to note that APC models show a slow upward trend in mortality risk between about 2011 and 2021.

From 1990 to 2021, the total population and the death burden of females decreased, while the death burden of males increased. However, in recent years, the death burden of colorectal cancer in Chinese population of different genders showed a slow upward trend, suggesting that the death burden is still severe. More attention should be paid to middle-aged and elderly males, to reduce the mortality burden of colorectal cancer, effective intervention measures should be strengthened in the high-risk population.