Public health · 2025
Burden of colorectal cancer attributable to high body-mass index in 204 countries and territories, 1990-2021: Results from the Global Burden of Disease Study 2021.
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Zhang Qiuxia, Feng Jia, Xu Zhijie, Guo Yi, Zhu Baolin, Qian Ping
Аннотация
OBJECTIVES: A strong association between high Body Mass Index (BMI) and Colorectal Cancer (CRC) has been well established. However, the global burden of CRC attributable to high BMI remains underexplored. This study aims to examine and analyze the burden of CRC linked to high BMI at global, regional, and national levels from 1990 to 2021.
STUDY DESIGN: A descriptive analysis of the Global Burden of Disease (GBD) Study 2021.
METHODS: Data on the number of deaths and disability-adjusted life years (DALYs), as well as age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), were extracted from the GBD 2021. Average annual percentage change (AAPC) was calculated to evaluate the temporal change in ASDR and ASMR using Joinpoint regression analysis. The Population Attributable Fractions (PAF) were used to analyze the CRC burden attributed to risk factors.
RESULTS: In 2021, the global deaths and DALYs of CRC attributed to high BMI were 99,270 deaths and 2,364,660 years respectively, more than double the figures from 1990. High SDI regions bore the greatest burden while low-middle and middle SDI regions experienced a faster rise, with individuals over 60 and males being the most affected. East Asia, particularly China, had the heaviest burden globally. ASMR and ASDR were correlated with SDI. The top five risk factors for CRC burden were a diet low in whole grains (17.72 %), a diet low in milk (15.10 %), a diet high in red meat (14.55 %), high BMI (9.69 %) and a diet low in calcium (8.20 %) in 2021.
CONCLUSION: High BMI is a significant risk factor for CRC, with aging, population growth, gender, and SDI contributing to geographic and temporal variations in the burden. These findings highlight the urgent need for targeted prevention strategies, especially in high-risk populations, and emphasize the role of obesity prevention, early screening, lifestyle and dietary modifications, and interventions such as AI-driven technologies to reduce the CRC burden.
STUDY DESIGN: A descriptive analysis of the Global Burden of Disease (GBD) Study 2021.
METHODS: Data on the number of deaths and disability-adjusted life years (DALYs), as well as age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), were extracted from the GBD 2021. Average annual percentage change (AAPC) was calculated to evaluate the temporal change in ASDR and ASMR using Joinpoint regression analysis. The Population Attributable Fractions (PAF) were used to analyze the CRC burden attributed to risk factors.
RESULTS: In 2021, the global deaths and DALYs of CRC attributed to high BMI were 99,270 deaths and 2,364,660 years respectively, more than double the figures from 1990. High SDI regions bore the greatest burden while low-middle and middle SDI regions experienced a faster rise, with individuals over 60 and males being the most affected. East Asia, particularly China, had the heaviest burden globally. ASMR and ASDR were correlated with SDI. The top five risk factors for CRC burden were a diet low in whole grains (17.72 %), a diet low in milk (15.10 %), a diet high in red meat (14.55 %), high BMI (9.69 %) and a diet low in calcium (8.20 %) in 2021.
CONCLUSION: High BMI is a significant risk factor for CRC, with aging, population growth, gender, and SDI contributing to geographic and temporal variations in the burden. These findings highlight the urgent need for targeted prevention strategies, especially in high-risk populations, and emphasize the role of obesity prevention, early screening, lifestyle and dietary modifications, and interventions such as AI-driven technologies to reduce the CRC burden.