Worldwide burden and cross-regional health inequalities of high BMI-attributable colorectal cancer by gender from 1990 to 2021, with predictions through 2041.

PURPOSE

To analyze the worldwide, regional, and national burden and trends of colorectal cancer (CRC) attributable to high body mass index (BMI) by gender from 1990 to 2021 and to forecast the burden through 2041.

METHODS

Data on deaths and disability-adjusted life years (DALYs) of CRC attributable to high BMI were obtained from the Global Burden of Disease (GBD) Study 2021. Disparities and trends in CRC due to high BMI burden were analyzed globally and regionally, with stratification by gender and age subgroups. An autoregressive integrated moving average (ARIMA) model was employed to project the future burden through 2041.

RESULTS

In 2021, the global age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) of CRC attributable to high BMI were estimated at 1.17 [95% uncertainty interval (UI): 0.51 to 1.87] and 27.33 (95% UI: 11.80 to 43.37) per 100,000 population, respectively. Both metrics showed a modest increase from 1990 to 2021. During this period, the population attributable fraction (PAF) of CRC deaths due to high BMI increased steadily. Similarly, the PAF of CRC DALYs caused by high BMI also showed a continuous rise. High socio-demographic index (SDI) regions, Central Europe and countries such as Hungary and Slovakia, recorded the highest ASMR and ASDR in 2021. Projections indicate that the global ASMR will decrease by 1%, while the ASDR will increase by 4.23% by 2041.

CONCLUSION

The global burden of CRC attributable to high BMI remains substantial and is projected to persist, with considerable regional and national variability. These findings emphasize the need for targeted public health interventions and policies to address this preventable risk factor.