Objective  To analyze the disease burden and trends of colorectal cancer (CRC) attributed to unhealthy diet risk factors in Chinese residents, in order to provide support for the formulation of nutrition and health management, cancer prevention and control management strategies.

Methods  Based on the Global Burden of Disease Study 2021 (GBD 2021) database, the CRC related data of Chinese residents from 1990 to 2021 due to unhealthy diet factors were extracted. Deaths, mortality, disability-adjusted life years (DALYs), years of life lost due to premature mortality (YLLs) and years lived with disability (YLDs) were used to assess CRC disease burden. Joinpoint regression analysis and age-period-cohort model were used to explore the time trend of CRC disease burden and its correlation with age, period and cohort effects.

Results  In 2021, the number of age-wide CRC deaths caused by unhealthy diet factors in Chinese residents was 102 700 [95% uncertain interval (UI): 36 100-166 500], and the standardized mortality rate was 5.08/100 000 (95%UI: 1.79/100 000-8.21/100 000), the standardized DALYs rate was 122.93/100 000 (95%UI: 42.56/100 000-198.49/100 000), the standardized YLLs rate was 117.14/100 000 (95%UI: 40.78/100 000-189.90/100 000), and the standardized YLDs rate was 5.79/100 000 (95%UI: 1.89/100 000-10.07/100 000). Among the unhealthy diet risk factors, the low-dairy diet contributed the most to CRC disease burden, while the low-fiber diets had the least impact. Joinpoint regression analysis revealed that the number of CRC deaths and the number of DALYs at all ages showed an overall upward trend, and the average annual percent change (AAPC) values were 237% and 187%, respectively. The standardized mortality rate and DALYs rate showed a decreasing trend, and the AAPC values were -81% and -88%, respectively. The age-period-cohort model analysis showed a decreasing trend in CRC mortality in general, men and women, with net drift values of -1.12% [95% confidence interval (CI): -1.25% to -0.99%], -0.46% (95%CI: -0.63% to -0.29%), and -2.07% (95%CI: -2.20% to -1.94%).

Conclusion  From 1990 to 2021, the CRC standardized mortality, standardized DALYs rate and standardized YLLs rate attributed to unhealthy diet risk factors in Chinese residents showed a decreasing trend, and the disease burden was relieved. From the perspective of gender, the CRC disease burden attributed to unhealthy diet risk factors was mainly caused by men; from the perspective of age, it was mainly caused by the middle-aged and old people; from the perspective of risk factor categories, it was mainly caused by low-dairy diet and low whole grain diet. Nutrition and health management, cancer prevention and control management strategies should pay attention to these special groups and categories, in order to reduce the burden of colorectal cancer.

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