The global burden of colorectal cancer attributable to high body-mass index in 204 countries and territories: findings from 1990 to 2021 and predictions to 2035

Abstract

Background: The association between high body-mass index (BMI) and colorectal cancer (CRC) has been confirmed and gained attention. However, a detailed understanding of the disease burden of high BMI and CRC remains lacking.

Objective: This study aimed to assess the temporal and geographical trends of CRC deaths and disability-adjusted life years (DALYs) caused by high BMI globally from 1990 to 2021, providing effective guidance for developing prevention and treatment strategies.

Methods: We used data from the 2021 Global Burden of Disease study to assess the global, regional, and national Deaths, DALYs, age-standardized mortality rate (ASMR), and age-standardized DALY rates (ASDR) caused by CRC related to high BMI, and further calculated the estimated annual percentage change (EAPC). We also considered factors such as gender, age, and sociodemographic index (SDI). We explore the relationship between EAPC and ASMR/ASDR (1990) and between EAPC and SDI (2021). Further, the autoregressive integrated moving average (ARIMA) model was applied to predict the disease burden from 2022 to 2035. The risk factors were calculated by Population Attributable Fraction (PAF).

Results: In 2021, CRC caused by high BMI resulted in 99,268 deaths (95% Uncertainty Interval (UI): 42,956-157,949) and 2,364,664 DALYs (95% UI: 1,021,594-3,752,340) globally, with ASMR and ASDR being 1.17 per 100,000 population (95% UI: 0.51-1.87) and 27.33 per 100,000 population (95% UI: 11.8-43.37), respectively. The disease burden was higher in males and the elderly, with significant differences between regions and sociodemographic groups. From 1990 to 2021, the ASMR for CRC associated with high BMI revealed little change globally, while the ASDR revealed an upward trend. The burden of CRC caused by high BMI has shifted from high SDI regions to low and low-middle SDI regions. Additionally, from 2022 to 2035, ASMR and ASDR are expected to increase in males, while ASMR and ASDR in females are expected to remain relatively stable.

Conclusion: From 1990 to 2021, the number of deaths and DALYs related to high BMI-associated CRC globally, as well as ASMR and ASDR, continue to rise. We predict that ASMR and ASDR may further increase by 2035, making it crucial to take timely and targeted interventions.

Keywords: colorectal cancer; disability adjusted life years; global burden; high body-mass index; mortality; sociodemographic index.

Figure 1

ASMR (A) and ASDR (B) for colorectal cancer attributable to high BMI by 5 SDI regions; the global number of deaths and ASMR for colorectal cancer attributable to high BMI by sex (C). The global number of DALYs and ASDR for colorectal cancer attributable to high BMI by sex (D); ASMR, age-standardized mortality rate; DALYs, disability-adjusted life-years; ASDR, age-standardized DALYs rate; SDI, sociodemographic index; BMI, body-mass index.

Figure 2

ASMR (A) and ASDR (B) for colorectal cancer attributable to high BMI in 204 countries in 2021; the percentage change in the number of deaths (C) and DALYs (D) for colorectal cancer attributable to high BMI from 1990 to 2021. The EAPC of the ASMR (E) and ASDR (F) for colorectal cancer attributable to high BMI from 1990 to 2021; ASMR, age-standardized mortality rate; ASDR, age-standardized DALYs rate; DALYs, disability-adjusted life-years; BMI, body-mass index; EAPC, estimated annual percentage change.

Figure 3

The global number of deaths (A) and DALYs (B) for colorectal cancer attributable to high BMI across age groups by sex and 5 SDI regions in 2021; The mortality rate (C) and DALYs rate (D) for colorectal cancer attributable to high BMI across age groups by 5 SDI regions in 2021; DALYs, disability-adjusted life-years; SDI, sociodemographic index; BMI, body-mass index.

Figure 4

The mortality rate (A) and DALYs rate (B) for colorectal cancer attributable to high BMI across age groups by sex in 2021; EAPC of the mortality rate for colorectal cancer attributable to high BMI across age groups by sex from 1990-2021 (C); EAPC of the mortality rate for colorectal cancer attributable to high BMI across age groups by 5 SDI from 1990-2021 (D); DALYs, disability-adjusted life-years; SDI, sociodemographic index; BMI, body-mass index; EAPC, estimated annual percentage change.

Figure 5

The correlation between ASMR for colorectal cancer attributable to high BMI and SDI (A); The correlation between ASDR for colorectal cancer attributable to high BMI and SDI (B); ASMR, age-standardized mortality rate; ASDR, age-standardized DALYs rate; SDI, sociodemographic index; BMI, body-mass index.

Figure 6

The correlation between ASMR for colorectal cancer attributable to high BMI in 1990 and EAPC of ASMR (A); The correlation between ASDR for colorectal cancer attributable to high BMI in 1990 and EAPC of ASDR (B); ASMR, age-standardized mortality rate; ASDR, age-standardized DALYs rate; BMI, body-mass index; EAPC, estimated annual percentage change.

Figure 7

The correlation between the EAPC of ASMR for colorectal cancer attributable to high BMI and SDI in 2021 (A); The correlation between the EAPC of ASDR for colorectal cancer attributable to high BMI and SDI in 2021 (B); ASMR, age-standardized mortality rate; ASDR, age-standardized DALYs rate; SDI, sociodemographic index; BMI, body-mass index; EAPC, estimated annual percentage change.

Figure 8

Projections of ASMR (A,C) and ASDR (B,D) for colorectal cancer attributable to high BMI in males and females from 2022 to 2035; The red line represents the actual value, and the fan represents the predicted distribution between the 2.5 and 97.5% quantiles. The forecast average is shown as a yellow dot. The vertical dotted line indicates where the prediction begins; ASMR, age-standardized mortality rate; ASDR, age-standardized DALYs rate; BMI, body-mass index.