Burden and Trends of Diet-Related Colorectal Cancer in OECD Countries: Systematic Analysis Based on Global Burden of Disease Study 1990-2021 with Projections to 2050

Abstract

Background: An unhealthy diet is a major risk factor for colorectal cancer (CRC). This study assessed the diet-related CRC burden from 1990 to 2021 in Organisation for Economic Co-operation and Development (OECD) nations and estimated the burden until 2050. Methods: Data for OECD countries on diet-related CRC disability-adjusted life years (DALYs) and deaths were obtained from the Global Burden of Disease 2021 study. The estimated annual percent change (EAPC) was calculated to analyse the CRC burden attributable to dietary factors. A generalised additive model with a negative binomial distribution was used to predict the future burden of CRC attributable to dietary factors from 2021 to 2050. Results: In 2021, the age-standardised percentages of diet-related CRC DALYs and deaths were 39.1% (95% uncertainty interval (UI): 9.3, 61.3) and 39.0% (95% UI: 9.7, 60.9), respectively, in the OECD countries. Between 1990 and 2021, the age-standardised DALYs decreased from 185 to 129 per 100,000, and deaths decreased from 8 to 6 per 100,000 population for OECD countries. Similarly, the EAPC in the rates showed a downward trend (EAPC_deaths = -1.26 and EAPC_DALYs = -1.20). The estimated diet-related CRC DALYs and deaths are projected to increase to 4.1 million DALYs and 0.2 million deaths by 2050. There is a downward trend in CRC deaths (EAPC = 1.33 for both sexes) and in DALYs (-0.90 for males and -1.0 for females) from 1990 to 2050. Conclusions: The diet-related CRC burden remains significant. Implementing nutrition intervention programmes is necessary to promote access to affordable and nutritious foods and raise awareness about the importance of a healthy diet in reducing CRC risk.

Keywords: colorectal neoplasms; death; diet; disability-adjusted life years; global burden of disease.

Figure 1

Proportion of diet-related CRC deaths by age group in OECD countries in 2021.

Figure 2

Proportion of diet-related CRC DALYs by age group in OECD countries in 2021.

Figure 3

Diet-related CRC burden by sex and age group from 1990 to 2021.

Figure 4

Diet-related rate of CRC burden by sex and age group from 1990 to 2021. Note: Estimate for 15–49 age group overlaps and line overlaps in Figure 4.

Figure 5

Specific diet–related age-standardised proportion of CRC deaths among OECD countries in 2021.

Figure 6

Specific diet–related age-standardised proportion of CRC DALYs among OECD countries in 2021.

Figure 7

Trends of specific diet–related CRC DALYs and deaths among OECD countries from 1990 to 2021. (A) Age-standardised percentage of CRC deaths, (B) age-standardised percentage of CRC DALYs.

Figure 8

Correlation between SDI and EAPC from 1990 to 2019. (A) Correlation between EAPC in ASDR and SDI in 1990, (B) correlation between EAPC in ASR of DALYs and SDI in 1990, (C) correlation between EAPC in ASDR and SDI in 2021, and (D) correlation between EAPC in ASR of DALYs and SDI in 2021. Note: Solid lines represent direction of association, and shaded areas represent 95% confidence interval. Dots indicate SDI values of each country. R represents Spearman correlation coefficient and p values indicate level of statistical significance. Abbreviations: ASDR = age-standardised death rate; DALYs = disability-adjusted life years; EAPC = estimated annual percentage of change, SDI = socio-demographic index.

Figure 9

Prediction of age-standardised rate and number of CRC DALYs and deaths attributed to dietary factors in OECD countries. (A) Number of CRC deaths, (B) number of CRC DALYs, (C) ASDR per 100,000 from 1990 to 2050, and (D) ASR of DALYs per 100,000 from 1990 to 2050. Abbreviations: ASDR = age-standardised death rate; ASR = age-standardised rate; DALYs = disability-adjusted life years.