Researchers looked at colorectal cancer cases around the world from 1990 to 2021 and found that the disease is becoming more common, especially in China and Africa. While death rates have improved in some places thanks to better treatments, millions of people still get this cancer each year. The study shows that things like being overweight, eating too much red meat, and not exercising enough are major risk factors we can actually control. Scientists say we need to shift from just treating cancer after it appears to catching it early and preventing it before it starts.

The Quick Take

  • What they studied: How colorectal cancer cases, deaths, and health problems have changed worldwide between 1990 and 2021, and what this means for the future
  • Who participated: This wasn’t a study with individual people. Instead, researchers analyzed data from the Global Burden of Disease database, which tracks health information from countries all around the world
  • Key finding: Colorectal cancer cases worldwide jumped by about 25% over 31 years, with 11.7 million people having the disease by 2021. China saw an even bigger increase of 141%, going from 0.6 million to 3.6 million cases. However, death rates actually dropped by about 21% globally, showing that treatments are getting better
  • What it means for you: If you live in China, Africa, or other developing areas, your risk of colorectal cancer may be increasing. The good news is that controlling your weight, eating less red meat, and exercising more can help prevent it. Early screening is becoming more important than waiting until you have symptoms

The Research Details

This study analyzed information from the Global Burden of Disease 2021 database, which is like a giant health record for the entire world. Researchers looked at numbers about how many people got colorectal cancer, how many died from it, and how much it affected people’s quality of life (measured by something called DALYs, which stands for disability-adjusted life years). They used computer programs to organize this data by age, sex, country, and region. They also looked at risk factors like body weight, diet, and exercise habits to understand what makes colorectal cancer more likely. The researchers then used this information to predict what might happen by the year 2050.

The study examined data from 1990 all the way to 2021, giving them 31 years of information to see trends and patterns. They paid special attention to China because it’s experiencing a very rapid increase in colorectal cancer cases. They also looked at differences between men and women, and between rich and poor countries, to understand who is most affected.

This type of research is important because it shows us the big picture of a disease across the whole world. Instead of just looking at one hospital or one country, researchers can see patterns that help governments and doctors plan better healthcare. By understanding which regions have the most cases and which risk factors matter most, doctors can focus prevention efforts where they’re needed most. This information also helps predict future problems so we can prepare now rather than being surprised later.

This study used data from the Global Burden of Disease database, which is one of the most respected sources of health information in the world. However, the quality depends on how accurate the original data from each country is. Some countries have better record-keeping than others, so numbers might not be perfectly accurate everywhere. The study is based on existing data rather than new experiments, which means it can show us trends but can’t prove that one thing directly causes another. The researchers used standard methods that other scientists use, which makes their work reliable and comparable to other studies.

What the Results Show

Between 1990 and 2021, colorectal cancer became more common worldwide. The number of people with the disease increased from 4.26 million to 11.7 million—an increase of about 25% when adjusted for population size and age. This is a significant jump that shows colorectal cancer is becoming a bigger health problem globally.

China experienced an even more dramatic increase. The number of colorectal cancer cases there more than doubled, jumping 141% from 0.6 million to 3.6 million people. This rapid growth in China is particularly important because it shows how quickly the disease can spread as countries become wealthier and lifestyles change.

The good news is that death rates from colorectal cancer actually went down by about 21% worldwide. This means that even though more people are getting the disease, fewer people are dying from it. This improvement is likely due to better screening methods, earlier detection, and improved treatments. However, this positive trend isn’t happening everywhere equally—some regions in Africa and Asia are still seeing increases in deaths and health problems from colorectal cancer.

Men are being hit harder by colorectal cancer than women. The disease burden is higher in men across most regions, meaning men get it more often and experience more serious health consequences from it.

The study identified three main things that increase your risk of colorectal cancer and that you can actually change: being overweight or obese (high BMI), eating a lot of red meat, and not getting enough physical activity. These are called ‘modifiable risk factors’ because you can do something about them. The research shows that focusing on these three areas could help prevent many cases of colorectal cancer.

Regional differences are significant. East Asia had 287,900 deaths from colorectal cancer, while North Africa and the Middle East had 37,400 deaths. When looking at DALYs (a measure of how much the disease affects people’s lives), East Asia had 7,149,000 and North Africa and the Middle East had 1,012,700. These numbers show that some regions are much more affected than others.

The study also looked ahead to 2050 and predicts that colorectal cancer cases will continue to rise, especially in China and Africa. This projection is based on current trends in population growth, aging, and lifestyle changes.

This research builds on previous Global Burden of Disease studies by providing the most recent data through 2021. Earlier studies showed that colorectal cancer was becoming more common, and this new research confirms that trend is continuing. The finding that death rates are declining while new cases are increasing matches what other researchers have found—it shows that we’re getting better at treating the disease, but we’re not doing as well at preventing it from happening in the first place. The emphasis on shifting toward prevention and early detection aligns with what health experts around the world have been recommending.

This study has some important limitations to understand. First, it relies on data reported by different countries, and some countries have much better health record-keeping than others. This means the numbers might not be equally accurate everywhere. Second, the study can show us that colorectal cancer is increasing and that certain risk factors are present, but it can’t prove that one thing directly causes another—it can only show associations. Third, the predictions for 2050 are based on current trends continuing, but unexpected changes in medicine, lifestyle, or technology could change these predictions. Finally, the study doesn’t include information about genetic factors or family history, which also play a role in colorectal cancer risk.

The Bottom Line

Based on this research, here are evidence-based recommendations: (1) If you’re in a high-risk region like China or Africa, or if you’re over 45-50 years old, talk to your doctor about colorectal cancer screening—this is supported by strong evidence. (2) Maintain a healthy weight through balanced eating and regular exercise—this is supported by strong evidence from this and other studies. (3) Limit red meat consumption and eat more vegetables, fruits, and whole grains—this is supported by moderate evidence. (4) Get at least 150 minutes of moderate physical activity per week—this is supported by strong evidence. These recommendations have moderate to strong confidence levels based on the research.

Everyone should care about this research, but especially: people living in China, Africa, and other developing countries where colorectal cancer is increasing rapidly; men, who have higher rates of the disease; people over 45-50 years old; people who are overweight; people who eat a lot of red meat; and people who don’t exercise regularly. People with a family history of colorectal cancer should definitely pay attention. However, even young, healthy people should start thinking about prevention now, since the habits you build today affect your health tomorrow.

If you start making lifestyle changes like exercising more, eating healthier, and maintaining a healthy weight, you might feel better and have more energy within weeks to months. However, the real benefit for colorectal cancer prevention takes years to show up. Cancer develops slowly over many years, so preventing it requires long-term commitment to healthy habits. If you get screening as recommended, early detection could catch cancer at a stage where it’s much easier to treat, potentially within months of screening.

Want to Apply This Research?

  • Track your weekly physical activity minutes (goal: 150 minutes of moderate activity), red meat servings per week (goal: reduce by 25-50%), and weight or BMI monthly. Use the app to log these three modifiable risk factors and watch your trends over time.
  • Set a specific, achievable goal like ‘Walk 30 minutes, 5 days per week’ or ‘Eat red meat no more than 2 times per week.’ Use the app to send you reminders and celebrate when you hit your targets. Start with one change rather than trying to do everything at once.
  • Create a monthly dashboard in the app that shows your progress on the three main risk factors: physical activity, diet quality (especially red meat reduction), and weight management. Review this dashboard monthly and adjust your goals based on what’s working. Share your progress with your doctor during annual check-ups, especially if you’re in a high-risk age group or region.

This research summary is for educational purposes only and should not replace professional medical advice. If you have concerns about colorectal cancer risk, symptoms like changes in bowel habits, blood in stool, or persistent abdominal pain, or questions about screening, please consult with your healthcare provider. The findings presented are based on epidemiological data and population trends; individual risk varies based on personal and family history, genetics, and other factors. Always discuss screening recommendations and prevention strategies with your doctor, as they may vary based on your age, risk factors, and regional guidelines.