ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Epidemiology and Prevention
This article is part of the Research TopicCancer Epidemiology: Patterns, Causes, and Therapeutic AdvancementsView all 6 articles
The global, regional, and national burden of colorectal cancer and its attributable risk factors in 204 countries and territories, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021
Provisionally accepted
- Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, China
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Background Colorectal cancer (CRC) is among the leading causes of cancer-related mortality worldwide. This study aimed to assess the global burden of CRC across 204 countries and territories from 1990 to 2021, and identify its attributable risk factors. Methods Estimates of CRC incidence, mortality, and disability-adjusted life years (DALYs) were derived from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, stratified by age, sex, and geographical region over the 1990–2021 period. Additionally, DALYs attributable to risk factors with established causal links to CRC were calculated. Results 100,000 population (95% uncertainty interval [UI]: 25.36–29.90), mortality rate 13.23 per 100,000 (95% UI: 12.04–14.19), and DALY rate 309.21 per 100,000 (95% UI: 287.52–331.52). The number of new CRC cases increased from 916,583 in 1990 to 2,194,143 in 2021. The age-standardized incidence rate (ASIR) rose from 24.0 to 25.6 per 100,000. High SDI (Socio-demographic Index) regions had the highest ASIR (40.5 per 100,000 in 2021), while low SDI regions had the lowest (7.4 per 100,000 in 2021). Between 1990 and 2021, the global age-standardized mortality rate (ASDR) decreased from 15.6 to 12.4 per 100,000, and the age-standardized DALY rate declined from 357.3 to 283.2 per 100,000. However, this reduction was uneven across SDI regions. Key risk factors included behavioral and metabolic factors, among which a diet low in whole grains significantly increased CRC incidence. Conclusion From 1990 to 2021, the global CRC burden increased significantly, with notable variations across SDI regions. While high SDI regions made progress in reducing mortality and DALYs, low SDI regions now face a heavier burden. Targeted interventions for modifiable risk factors and improved healthcare access in less developed regions are essential to mitigate the global impact of CRC.
Keywords: GBD, colorectal cancer, SDI, risk factor, DALYs
Received: 06 Aug 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Wang, Tian and Wei. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dong Wei, wd150yyw5k@yeah.net
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