The global, regional, and national burden of colorectal cancer attributable to smoking from 1990 to 2021: a population-based study

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide, with smoking being a significant risk factor. Understanding the temporal and spatial patterns of the CRC burden attributable to smoking is crucial for global public health strategies. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were used to calculate the number of deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR) per 100 000 population, and age-standardized disability-adjusted life year rate (ASDR). The average annual percentage change (AAPC) was calculated from 1990 to 2021 to analyze disease burden trends. Frontier analysis was conducted to assess efficiency, and predictions were made for the next decade. In 2021, the global death toll and DALYs attributable to smoking were 47 613 and 1 235 667, respectively. From 1990 to 2021, the absolute number of deaths and DALYs increased, while ASMR (AAPC: −1.20) and ASDR (AAPC: −1.22) showed a significant decline. The disease burden was notably higher in males than females. Analysis by the Social Development Index revealed that more developed regions had a higher burden than less developed areas. China ranked first in the number of deaths and DALYs, while Greenland had the highest ASMR and ASDR. From 1990 to 2021, the age-standardized burden of CRC attributable to smoking decreased globally. However, the absolute burden remains a significant public health challenge, requiring sustained and targeted interventions.