Global burden and cross-country health inequalities of early-onset colorectal cancer and its risk factors from 1990 to 2021 and its projection until 2036

Sep 21, 2026

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Purpose: Explore the worldwide, regional, and country-specific burden of early-onset colorectal cancer (EOCRC) and determine associated risk factors from 1990 to 2021, then project incidence and mortality through 2036. Methods: Use Global Burden of Disease Study 2021 data by gender, SDI, and risk factors; apply joinpoint regression for burden trends and ARIMA for forecasting. Results: In 2021, incidence 5.37, prevalence 34, mortality 2.01 per 100,000, and DALYs 101.37; prevalence and incidence rise, mortality and DALYs fall; low-whole-grains diet is key risk. Forecasts indicate incidence ASR +5.56% and mortality ASR -13.9% by 2036.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages20

Reading Time50 min

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Abstract

Purpose

Methods

Results

1990 to 2021 trends

2021 burden estimates and risk factor

Projection to 2036

Conclusion

Keywords

Zhang et al. BMC Public Health (2024) 24:3124 [https://doi.org/10.1186/s12889-024-20624-4](https://doi.org/10.1186/s12889-024-20624-4) BMC Public Health RESEARCH Open Access Global burden and cross-country health inequalities of early-onset colorectal cancer and its risk factors from 1990 to 2021 and its projection until 2036 Jinhai Zhang1, Dehua Ou2, Aosi Xie1, Diqun Chen1 and Xinxin Li 1* Abstract Purpose To explore the worldwide, regional, and country-specific burden of early-onset colorectal cancer (EOCRC) and identify its associated risk factors between 1990 and 2021, and to project its incidence and mortality rates for 2036. Methods We acquired data on EO-CRC categorized by gender, socio-demographic index (SDI), and risk factors based on the Global Burden of Disease (GBD) Study 2021. Joinpoint regression analysis was utilized to explore the variation in disease burden. The autoregressive integrated moving average (ARIMA) model was performed to forecast the disease burden up to 2036. Results Globally, the incidence rate, prevalence rate, mortality rate, and disability-adjusted life years (DALYs) rate of EO-CRC were estimated at 5.37 (95%UI: 4.91 to 5 . 86)/100,000, 34 (95%UI: 30.96 to 37 . 35)/100,000, 2.01 (95%UI: 1.84 to 2 . 19)/100,000, and 101.37 (95%: 92.85 to 110. 18)/100,000 in 2021. The prevalence and incidence rates of EO-CRC showed an ascending trajectory, whilst the DALYs and mortality rates demonstrated a downward trajectory between 1990 to 2021. The high-middle SDI regions and East Asia exhibited the highest EO-CRC burden among the five SDI regions and 21 GBD regions respectively. A low-whole-grains diet was the chief risk factor contributing to EO-CRC. It was predicted that the age-standardized rate (ASR) of EO-CRC incidence would increase by 5 . 56%, while the ASR of mortality would decrease by 13. 9% globally until 2036. Conclusion The current and future global burden of EO-CRC is heavy and varies significantly across different regions and countries. Keywords Early-onset colorectal cancer, Global burden of disease, Disability-adjusted life years *Correspondence: Xinxin Li[xxli2023@163.com](xxli2023@163.com) 1 Department of Gastrointestinal Surgery, The First Affiliated Hospital of Shantou University Medical College, No. 57, Changping Road, Shantou, Guangdong Province 515041, China 2 Department of Urology, The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China Introduction Gastrointestinal cancers is a collective term for common malignant tumors of the digestive system, including esophageal cancer, gastric cancer, liver cancer, colorectal cancer (CRC), pancreatic cancer, and gallbladder cancer. These cancers account for one-fourth of all global cancer cases and one-third of cancer-related deaths, making them one of the major global health issues [1]. It is well known that gastrointestinal cancers primarily affect the © The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc

FAQs

What is the study’s main purpose for early-onset colorectal cancer?

To quantify global, regional, and country-specific burden of early-onset colorectal cancer from 1990–2021, identify associated risk factors, and project incidence and mortality rates through 2036.

How were disease burden trends and future projections analyzed?

Joinpoint regression was used to assess variations in disease burden over time, and an ARIMA model was applied to forecast burden up to 2036.

What did the results show about global trends between 1990 and 2021?

Prevalence and incidence rates increased, while DALYs and mortality rates decreased from 1990 to 2021.

Which risk factor was identified as a major contributor to EO-CRC?

A low-whole-grains diet was reported as the chief risk factor contributing to EO-CRC.

Sep 21, 2026

Uploaded by Quinn