Objective To analyze the disease burden and future trends of early-onset colorectal cancer (EOCRC) attributable to dietary risks in China from 1990 to 2021.

Methods Based on Global Burden of Disease 2021 (GBD 2021) database, the mortality and disability-adjusted life years (DALYs) rates of EOCRC attributable to dietary risks in China, globally, and across different socio-demographic index (SDI) regions from 1990 to 2021 were obtained. The Joinpoint regression model was applied to calculate the annual percent change (APC), average annual percent change (AAPC), and 95% confidence interval (CI) between turning points in age-standardized mortality rate and age-standardized DALYs rate, while an autoregressive integrated moving average (ARIMA) model was used to predict the disease burden from 2022 to 2035.

Results From 1990 to 2021, the standardized mortality and standardized DALYs rate of EOCRC attributed to dietary risks in China both showed a downward trend. The standardized mortality decreased from 2.37/100 000 in 1990 [95% uncertainty interval (UI): 1.07/100 000, 3.53/100 000] to 1.62/100 000 in 2021 (95%UI: 0.52/100 000, 2.69/100 000), with an AAPC of -1.25 (95%CI: -1.29, -1.22); the standardized DALYs rate decreased from 117.78/100 000 in 1990 (95% UI: 53.48/100 000, 175.53/100 000) to 82.88/100 000 in 2021 (95%UI: 26.47/100 000, 136.59/100 000), with an AAPC of -1.16 (95%CI: -1.20, -1.12). Among different dietary risk factors, only the standardized mortality and standardized DALYs rate of EOCRC attributed to high processed meat diet showed an upward trend, with AAPCs of 1.29 (95%CI: 1.24, 1.33) and 1.38 (95%CI: 1.33, 1.43), respectively. It is predicted that by 2035, the standardized mortality and standardized DALYs rate of EOCRC attributed to dietary risks in China will increase to 1.81/100 000 [95% prediction interval (PI): 1.00/100 000, 2.61/100 000] and 92.12/100 000 (95% PI: 40.05/100 000, 144.19/100 000), respectively.

Conclusion From 1990 to 2021, the disease burden of EOCRC attributed to dietary risks in China showed a downward trend, but it remained higher than that of the global and different SDI regions. Moreover, the disease burden is projected to continue to rise in the future. Attention should be paid to dietary structure intervention and health education for the young population, to increase the coverage of early screening for EOCRC, and to reduce the disease burden.

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