Distributions and trends in colorectal cancer disease burden attributable to dietary risks across countries with different dietary patterns (1990–2021)

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Abstract Objectives The incidence of colorectal cancer (CRC) continues to rise steadily, imposing a substantial disease burden on countries worldwide. This study aims to analyze the changing trends in CRC disease burden attributed to dietary risk factors, providing a foundation for strategies to mitigate the burden of CRC arising from dietary influences. Methods Using data from the Global Burden of Disease (GBD) 2021 study, CRC mortality rates and Disability-Adjusted Life Years (DALYs) attributed to specific dietary risk factors (including diets low in calcium, milk, whole grains, or fiber, and diets high in red meat and processed meat) were analyzed across five countries: the United States, Italy, China, Japan, India. The average annual percentage change (AAPC) was calculated using Joinpoint 5.0 software to illustrate the variations in CRC burden across different time frames and age groups. Results In 2021, dietary risk factors contributed to more than 65 % of the age-standardized mortality rate (ASMR) for CRC across the five countries. From 1990 to 2021, ASMR and age-standardized DALYs attributable to dietary risks for CRC declined across five countries: the United States [AAPC (95 % CI): −1.52 (−1.64, −1.40), −1.23 (−1.49, −0.97)], Italy [AAPC (95 % CI): −1.05 (−1.15, −0.95), −1.19 (−1.28, −1.10)], China [AAPC (95 % CI): −0.81 (−0.99, −0.63), −0.88 (−1.03, −0.72)], Japan [AAPC (95 % CI): −0.54 (−0.73, −0.36), −0.66 (−0.89, −0.42)], and India [AAPC (95 % CI): −0.03 (−0.41, 0.35), −0.19 (−0.34, −0.03)]. The United States and Italy demonstrated the most significant reductions in CRC disease burden related to diets low in milk (AAPC: −1.77 vs. −1.87), whole grain (AAPC: −1.28 vs. −1.13), and high in red meat (AAPC: −1.27 vs. −1.18) and processed meat (AAPC: −0.86 vs. −0.98) (p<0.05). Conversely, China and Japan experienced a higher CRC disease burden linked to diets low in calcium (AAPC: −3.07 vs. −0.91) and milk (AAPC: −0.58 vs. −0.78) (p<0.05). Notably, in the United States, CRC burden exhibited a trend toward affecting younger populations. Conclusions Poor dietary habits significantly contribute to the CRC disease burden, with diets low in milk and whole grains, and high in meat identified as major risk factors. Promoting healthy eating habits is essential to reduce this burden and improve public health outcomes.