Global, regional, and national burden of colorectal cancer associated with diet high in red meat, 1990 to 2021: an analysis for the global burden of disease study and prediction to 2036

Abstract

Objective: To evaluate the global, regional, and national burden of colorectal cancer (CRC) attributable to diets high in red meat from 1990 to 2021, project trends to 2036, and stratify findings by age, sex, and Sociodemographic Index (SDI).

Methods: Data on CRC burden associated with diet high in red meat were extracted from the Global Health Data Exchange (GHDx). Age-standardized rates (ASR) and estimated annual percentage change (EAPC) were calculated to assess temporal trends. Inequality slope and concentration indices quantified health disparities, while decomposition analyses identified drivers of burden changes. A Bayesian age-period-cohort (BAPC) model projected future trends through 2036.

Results: From 1990 to 2021, age-standardized mortality rates (EAPC = − 0.84%, 95% CI: − 0.87 to − 0.81) and disability-adjusted life years (DALYs) (EAPC = − 0.85, 95% CI: − 0.88 to − 0.81) for CRC attributable to high red meat intake declined globally. The reduction in DALYs was driven by decreasing years of life lost (YLLs; EAPC = − 0.9, 95% CI: − 0.93 to − 0.86), contrasting with rising years lived with disability (YLDs; EAPC = 0.45, 95% CI: 0.41–0.48). Males and older populations bore a disproportionate burden. Global population growth accounted for 99.73% of increased deaths, 112.77% of DALYs, 62.42% of YLDs, and 116.5% of YLLs. Inequality slope indices for mortality remained stable, while concentration indices for DALYs declined (deaths: 0.31 [95% CI: 0.28–0.34] to 0.26 [0.23–0.29]). Projections indicate declining age-standardized mortality and DALY rates by 2036, but absolute deaths, DALYs, and YLLs are expected to rise.

Conclusion: Despite declining age-standardized rates, the absolute burden of CRC associated with diet high in red meat persists, with marked disparities across regions and demographics. Population growth remains a critical driver, underscoring the need for targeted dietary interventions and equity-focused policies.

Supplementary Information: The online version contains supplementary material available at 10.1186/s12889-025-23712-1.

Keywords: Colorectal cancer; Decomposition; Disability-adjusted life years; Global burden of disease; Health inequality; Red meat.

Fig. 1

Global burden of high-red meat colorectal cancer and its age-standardized rates from 1990 to 2021. DALYs = disability-adjusted life-years. YLDs = years lived with disability. YLLs = years of life lost

Fig. 2

Global distribution maps for the burden of colorectal cancer burden associated with a diet high in red meat in 204 countries and territories in 2021. A ASR of Deaths; B ASDR; C ASYR; D ASSR

Fig. 3

A Temporal trend point plots of the global colorectal cancer burden associated with a diet high in red meat and B) age-standardized rates by age from 1990 to 2021. DALYs = disability-adjusted life-years, YLDs = years lived with disability. YLLs = years of life lost

Fig. 4

A Burden of colorectal cancer associated with diet high in red meat by SDI from 1990 to 2021; B ASR of CRC burden associated with diet high in red meat by SDI from 1990 to 2021. SDI = socio-demographic index. DALYs = disability-adjusted life-years. YLDs = years lived with disability. YLLs = years of life lost

Fig. 5

Age-standardized Deaths (A), DALYs (B), YLDs (C) and YLLs (D) rates for colorectal cancer associated with diet high in red meat SDI for both sexes, by region, 1990–2021.Black line shows the expected values by SDI based on a regression of all years of data for all GBD locations between 1990 and 2021. DALY = disability-adjusted life-year. YLDs = years lived with disability. YLLs = years of life lost. SDI = Socio-demographic Index

Fig. 6

Age-standardized Deaths (A), DALYs (B), YLDs (C) and YLLs(D) rates for colorectal cancer associated with diet high in red meat SDI for both sexes, by country, 1990–2021.Black line shows the expected values by SDI based on a regression of all years of data for all GBD locations between 1990 and 2021. DALY = disability-adjusted life-year. YLDs = years lived with disability. YLLs = years of life lost. SDI = Socio-demographic Index

Fig. 7

Health inequality regression and concentration curves for Deaths (A,B), DALYs (C,D), YLDs (E,F) and YLLs (G,H) of colorectal cancer associated with diet high in red meat across 204 counties and territories, 1990 and 2021.DALY = disability-adjusted life-year. YLDs = years lived with disability. YLLs = years of life lost. SDI = Socio-demographic Index

Fig. 8

Changes in colorectal cancer associated with diet high in red meat Deaths (A), DALYs (B), YLDs (C) and YLLs (D) according to population-level determinants of population growth, aging, and epidemiological change from 1990 to 2021 at the global level and by SDI quintile and 21 regions. The black dot represents the overall value of change contributed by all 3 components. For each component, the magnitude of a positive value indicates a corresponding increase in colorectal cancer associated with diet high in red meat Deaths, DALYs, YLDs and YLLs attributed to the component. SDI = Socio-demographic index. DALY = disability-adjusted life-year. YLDs = years lived with disability. YLLs = years of life lost. SDI = Socio-demographic Index

Fig. 9

Projections of ASDR (A), ASLR (B), ASYR (C) and ASSR (D) in males, females and both sexes of colorectal cancer associated with diet high in red meat from 2021 to 2030. Total global cases of colorectal cancer associated with high red forecasted to the year 2036.Shaded areas represent 95% uncertainty intervals. DALY = disability-adjusted life-year. YLDs = years lived with disability. YLLs = years of life lost