Evolving landscape of geriatric colorectal cancer: Global and regional burden, risk factor dynamics, and future scenarios (the Global Burden of Disease 1990–2040)

Geriatric patients diagnosed with colorectal cancer (GCRC) face elevated rates of mortality and complications; however, yet current guidelines lack randomized controlled trial (RCT) data specifically for individuals aged 75 and above (75+). Although the burden of colorectal cancer in the global population aged 65 and older has decreased, the trends in 75+ colorectal cancer patients have not been studied. This study assessed the prevalence, incidence, mortality, and Disability-Adjusted Life Years (DALYs) of geriatric colorectal cancer at global and national levels from 1990 to 2021, and projects trajectories to 2045. Using data from the 2021 Global Burden of Disease (GBD) study, we calculated age-standardized rates (ASRs) for 204 countries/regions. Joinpoint regression identified time trends through Average Annual Percentage Changes (AAPCs), while Bayesian Age-Period-Cohort models (BAPC) predicted future burdens. Globally, the burden of colorectal cancer in the population aged 75+ has decreased (AAPC of ASDR: −14.832, 95% UI: −15.179 to -14.485). However, the prevalence has significantly increased, with an average annual increase of 4.491 (95% UI: 4.347-4.635), and a much larger increase in males compared to females (9.313 [95% UI: 9.101-9.526] vs. 0.564 [95% UI: 0.380-0.748]). Major risk factors include a diet lacking whole grains, insufficient milk intake, high red meat consumption, and lack of physical exercise, which are the main causes of mortality and DALYs. Predictions indicate that by 2040, the prevalence of GCRC will increase globally, especially among males (with an expected increase of 44% in prevalence from 1990 to 2040). The burden of disease in the geriatric population aged 75+ is expected to continue to rise, with significant gender differences. Public health efforts should focus on changing dietary structures and increasing physical exercise. This study emphasizes the urgent need for intervention strategies targeting geriatric patients to address the evolving epidemiological challenges in colorectal cancer prevention and control.