Burden and risk factors of colorectal cancer in Europe from 1990 to 2021

Background Colorectal cancer (CRC) poses a significant health burden in Europe, but comprehensive studies on this region are limited. Methods Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2021, we analyzed the regional distribution and temporal trends of the CRC and early-onset CRC burden in Europe from 1990 to 2021. Decomposition analysis was applied to quantify the contributions of population growth, aging, and epidemiological changes. The research also evaluated major risk factors associated with CRC and early-onset CRC. Results The burden of CRC in Europe was found to be higher than the global average. While the age-standardized incidence rate (ASIR) increased, both the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life years rate (ASDR) decreased. Early-onset CRC exhibits similar distribution characteristics and patterns of change. Males had a significantly higher CRC burden than females. Population aging was the primary driver of increased burden in Europe. Risk factor analysis revealed that low whole grain intake and high red meat consumption were the primary contributors to the elevated ASMR and ASDR of CRC and early-onset CRC. Additionally, the CRC and early-onset CRC burden associated with high BMI and high fasting plasma glucose showed an increasing trend. Conclusion The overall burden of CRC and early-onset CRC in Europe remains higher than the global level, with increasing ASIR and decreasing ASMR and ASDR. Targeted prevention and control strategies should be developed based on the major risk factors for CRC. Older adults and men should be prioritized for interventions.