Global, regional and national burden of colon and rectum cancer: a systematic analysis of prevalence, incidence, deaths and DALYs from 1990 to 2021 using data from the Global Burden of Disease Study 2021 with projections to 2036.

Objectives: Colon and rectum cancer, the third most common cancer globally, is a considerable health challenge worldwide. Despite the excellent insights offered by the global burden of disease (GBD) study, comprehensive assessments of colon and rectum cancer remain limited. This study utilises the most recent GBD dataset to examine the impacts of colon and rectum cancer, incorporating contemporary data alongside projections for 2036.

Methods: We analysed data from the 2021 GBD database, focusing on metrics pertaining to colon and rectum cancer: prevalence, incidence, mortality and disability-adjusted life years (DALYs) across 204 countries and territories, classified into 21 GBD regions and five sociodemographic index (SDI) regions. The data analysis encompassed computations of relative change, annual percentage change and estimated annual percentage change. This research also employed the Pearson algorithm to investigate the relationship between disease burden and SDI, conduct cross-country inequality analysis, perform age-period-cohort analysis and execute decomposition analysis. Finally, an autoregressive integrated moving average model was utilised to project trends over the next 15 years.

Results: From 1990 to 2021, the global prevalence of colon and rectum cancer increased significantly, from approximately 4.27 million to 11.68 million cases (age-standardised prevalence rate increased from ~108.25 to 134.84 per 100 000). Incident cases rose by 139.38% (age-standardised incidence rate increased by 6.52%). Mortality increased by 83.07% but with a significant decrease in age-standardised mortality rate (-20.33%), and DALYs increased by 69.49% with a corresponding decrease in age-standardised DALYs (-20.73%). Data on gender from 1990 to 2021 indicates that men experience a greater disease burden than women. A significant correlation exists between the illness burden of SDI and colon and rectum cancer, and the age-period-cohort model has provided further insights. Decomposition analysis reveals that population growth is the primary factor affecting the burden of colon and rectum cancer disease. The predictive study for the forthcoming 15 years indicates that while the mortality and DALYs for both genders will persist in their reduction, the prevalence and incidence rates for males will continue to increase, whereas those for women will remain relatively stable.

Conclusions: The burden of colon and rectum cancer has markedly escalated worldwide in the last 30 years. Essential methods to mitigate this trend encompass the reduction of modifiable risk factors, enhancement of early identification and treatment, and augmentation of early screening, particularly for high-risk male populations under 50 years of age. The rising incidence rate among youth underscores the necessity to enhance comprehension of developing risk factors and mechanisms, as well as to advance research on disease prevention and control techniques.