China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)

BackgroundColorectal cancer (CRC) is a major global and Chinese public health issue, and dietary factors are controllable risk factors. However, China’s CRC epidemiological trends and diet-attributable analyses based on the latest global burden of disease (GBD) data remain incomplete. This study sys...

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Main Authors: Qin Sun, Dengjun Bi, Yueshan Pang, Jiebin Xie
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2025.1590117/full
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author Qin Sun
Qin Sun
Dengjun Bi
Dengjun Bi
Yueshan Pang
Jiebin Xie
Jiebin Xie
author_facet Qin Sun
Qin Sun
Dengjun Bi
Dengjun Bi
Yueshan Pang
Jiebin Xie
Jiebin Xie
author_sort Qin Sun
collection DOAJ
description BackgroundColorectal cancer (CRC) is a major global and Chinese public health issue, and dietary factors are controllable risk factors. However, China’s CRC epidemiological trends and diet-attributable analyses based on the latest global burden of disease (GBD) data remain incomplete. This study systematically assessed China’s CRC disease burden (1990–2021) and temporal trends in diet-related risk factors via GBD 2021 data to inform precision prevention.MethodsGBD 2021 data were used to analyze age/sex differences in the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and diet-related risk factors for CRC. Temporal trends in CRC burden were evaluated via joinpoint regression analysis. To enable comparisons across populations with differing age structures, we calculated age-standardized rates (ASRs) via the GBD world standard population. The estimated annual percentage change (EAPC) trends were assessed.ResultsIn 2021, China had 658321.36 new CRC cases (315.63% increase vs. 1990) and 275129.23 deaths (130.61% increase), with males showing greater burden increases. The 15–49-year-old had the fastest incidence growth (EAPC = 3.40%); those ≥75 years of age had the highest incidence (255.34/100000 people). Among the dietary risk factors, low milk intake caused the most deaths in 2021 (51030.32 cases), followed by low whole grain intake (49990.79 cases). From 1990 to 2021, processed meat-related deaths rose the most (274.71%), with higher proportions of young adults; low-calcium diet deaths significantly declined (EAPC = -0.48%). Females had the highest share of low-milk deaths, whereas males had the most low-whole-grain deaths.ConclusionChina’s CRC burden is increasing overall, with increasing sex differences and coexisting youth and later life trends, driven by dietary shifts. Urgent promotion of increased milk and whole-grain intake, alongside reduced processed meat consumption, is needed, with tailored strategies for different populations.
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spelling doaj-art-b21d8fb268cc42cfb93c4b4d1aa684a42025-08-20T03:51:25ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-07-011210.3389/fnut.2025.15901171590117China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)Qin Sun0Qin Sun1Dengjun Bi2Dengjun Bi3Yueshan Pang4Jiebin Xie5Jiebin Xie6Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, ChinaNorth Sichuan Medical College, Nanchong, Sichuan, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, ChinaNorth Sichuan Medical College, Nanchong, Sichuan, ChinaDepartment of General Practice, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, Sichuan, ChinaDepartment of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, ChinaNorth Sichuan Medical College, Nanchong, Sichuan, ChinaBackgroundColorectal cancer (CRC) is a major global and Chinese public health issue, and dietary factors are controllable risk factors. However, China’s CRC epidemiological trends and diet-attributable analyses based on the latest global burden of disease (GBD) data remain incomplete. This study systematically assessed China’s CRC disease burden (1990–2021) and temporal trends in diet-related risk factors via GBD 2021 data to inform precision prevention.MethodsGBD 2021 data were used to analyze age/sex differences in the incidence, prevalence, mortality, disability-adjusted life years (DALYs) and diet-related risk factors for CRC. Temporal trends in CRC burden were evaluated via joinpoint regression analysis. To enable comparisons across populations with differing age structures, we calculated age-standardized rates (ASRs) via the GBD world standard population. The estimated annual percentage change (EAPC) trends were assessed.ResultsIn 2021, China had 658321.36 new CRC cases (315.63% increase vs. 1990) and 275129.23 deaths (130.61% increase), with males showing greater burden increases. The 15–49-year-old had the fastest incidence growth (EAPC = 3.40%); those ≥75 years of age had the highest incidence (255.34/100000 people). Among the dietary risk factors, low milk intake caused the most deaths in 2021 (51030.32 cases), followed by low whole grain intake (49990.79 cases). From 1990 to 2021, processed meat-related deaths rose the most (274.71%), with higher proportions of young adults; low-calcium diet deaths significantly declined (EAPC = -0.48%). Females had the highest share of low-milk deaths, whereas males had the most low-whole-grain deaths.ConclusionChina’s CRC burden is increasing overall, with increasing sex differences and coexisting youth and later life trends, driven by dietary shifts. Urgent promotion of increased milk and whole-grain intake, alongside reduced processed meat consumption, is needed, with tailored strategies for different populations.https://www.frontiersin.org/articles/10.3389/fnut.2025.1590117/fullcolorectal cancer (CRC)global burden of disease (GBD)dietary risk factorscolon cancerrectal cancer
spellingShingle Qin Sun
Qin Sun
Dengjun Bi
Dengjun Bi
Yueshan Pang
Jiebin Xie
Jiebin Xie
China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)
Frontiers in Nutrition
colorectal cancer (CRC)
global burden of disease (GBD)
dietary risk factors
colon cancer
rectal cancer
title China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)
title_full China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)
title_fullStr China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)
title_full_unstemmed China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)
title_short China’s colorectal cancer burden and dietary risk factors: a temporal analysis (1990–2021)
title_sort china s colorectal cancer burden and dietary risk factors a temporal analysis 1990 2021
topic colorectal cancer (CRC)
global burden of disease (GBD)
dietary risk factors
colon cancer
rectal cancer
url https://www.frontiersin.org/articles/10.3389/fnut.2025.1590117/full
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