{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T12:26:43Z","timestamp":1793363203117,"version":"4.5.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T00:00:00Z","timestamp":1746144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82404328"],"award-info":[{"award-number":["82404328"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"First-Class Discipline Team of Kunming Medical University","award":["2024XKTDTS06"],"award-info":[{"award-number":["2024XKTDTS06"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"DOI":"10.1186\/s12876-025-03948-2","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T13:13:23Z","timestamp":1746191603000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Global burden of colon and rectal cancer and attributable risk factors in 204 countries and territories from 1990 to 2021"],"prefix":"10.1186","volume":"25","author":[{"given":"Xuyuan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyu","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sen","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanxia","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuyang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenliang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"3948_CR1","unstructured":"Cancer. https:\/\/www.who.int\/health-topics\/cancer. Accessed on 14 July 2021."},{"key":"3948_CR2","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1038\/s41575-019-0189-8","volume":"16","author":"N Keum","year":"2019","unstructured":"Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol. 2019;16:713\u201332.","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"10","key":"3948_CR3","first-page":"1293","volume":"43","author":"C Huang","year":"2018","unstructured":"Huang C. New advances in the diagnosis and treatment of colorectal cancer. J Bengbu Med Coll. 2018;43(10):1293\u20137. [in Chinese].","journal-title":"J Bengbu Med Coll"},{"key":"3948_CR4","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1016\/S2468-1253(22)00044-9","volume":"7","author":"GBD 2019 Colorectal Cancer Collaborators","year":"2022","unstructured":"GBD 2019 Colorectal Cancer Collaborators. Global, regional, and National burden of colorectal cancer and its risk factors, 1990\u20132019: a systematic analysis for the global burden of disease study 2019. Lancet Gastroenterol Hepatol. 2022;7:627\u201347.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"3948_CR5","doi-asserted-by":"crossref","unstructured":"Wj G, Jp P, K JLNA. H, S O, The burden of early-onset colorectal cancer and its risk factors from 1990 to 2019: A systematic analysis for the global burden of disease study 2019. Cancers. 2022;14.","DOI":"10.3390\/cancers14143502"},{"key":"3948_CR6","first-page":"436","volume":"52","author":"E Kazemi","year":"2023","unstructured":"Kazemi E, Zayeri F, Baghestani A, Bakhshandeh M, Hafizi M. Trends of colorectal Cancer incidence, prevalence and mortality in worldwide from 1990 to 2017. Iran J Public Health. 2023;52:436\u201345.","journal-title":"Iran J Public Health"},{"key":"3948_CR7","doi-asserted-by":"crossref","unstructured":"Y T, X YLJM. Y, S W, J J, Global, regional, and National burden of thalassemia, 1990\u20132021: a systematic analysis for the global burden of disease study 2021. EClinicalMedicine. 2024;72.","DOI":"10.1016\/j.eclinm.2024.102619"},{"key":"3948_CR8","doi-asserted-by":"publisher","first-page":"2100","DOI":"10.1016\/S0140-6736(24)00367-2","volume":"403","author":"GBD 2021 Causes of Death Collaborators","year":"2024","unstructured":"GBD 2021 Causes of Death Collaborators. Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990\u20132021: a systematic analysis for the global burden of disease study 2021. Lancet. 2024;403:2100\u201332.","journal-title":"Lancet"},{"key":"3948_CR9","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(24)00933-4","volume":"403","author":"GBD 2021 Risk Factors Collaborators","year":"2024","unstructured":"GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990\u20132021: a systematic analysis for the global burden of disease study 2021. Lancet. 2024;403:2162\u2013203.","journal-title":"Lancet"},{"key":"3948_CR10","doi-asserted-by":"publisher","first-page":"106165","DOI":"10.1016\/j.ijsu.2021.106165","volume":"96","author":"G Mathew","year":"2021","unstructured":"Mathew G, Agha R, Albrecht J, Goel P, Mukherjee I, Pai P, et al. STROCSS 2021: strengthening the reporting of cohort, cross-sectional and case-control studies in surgery. Int J Surg. 2021;96:106165.","journal-title":"Int J Surg"},{"key":"3948_CR11","unstructured":"World Cancer Research Fund. Diet, Nutrition, Physical Activity and cancer: a Global Prespective. Summary-of-Third-Expert-Report-2018.pdf."},{"key":"3948_CR12","unstructured":"Cancer Institute NSW. Apr. Stop the chat, do the test. https:\/\/www.cancer.nsw.gov.au\/dothetest\/simplified-chinese.htm?utm_source=chatgpt.com. Accessed 12 2025."},{"key":"3948_CR13","unstructured":"Canadian Cancer Society. Get screened for colorectal cancer. https:\/\/cancer.ca\/en\/cancer-information\/find-cancer-early\/get-screened-for-colorectal-cancer. Accessed 12 Apr 2025."},{"key":"3948_CR14","unstructured":"National Cancer Institute. Colorectal Cancer Screening\u2014Cancer Trends Progress Report. https:\/\/progressreport.cancer.gov\/detection\/colorectal_cancer. Accessed 12 Apr 2025."},{"key":"3948_CR15","unstructured":"National Health Service (NHS). Bowel cancer screening. https:\/\/www.nhs.uk\/conditions\/bowel-cancer-screening\/. Published 2017. Accessed 12 Apr 2025."},{"key":"3948_CR16","unstructured":"Thanikachalam K, Khan G. Colorectal Cancer and Nutrition."},{"key":"3948_CR17","doi-asserted-by":"publisher","first-page":"813","DOI":"10.1016\/S0140-6736(25)00355-1","volume":"405","author":"M Ng","year":"2025","unstructured":"Ng M, Gakidou E, Lo J, Abate YH, Abbafati C, Abbas N, et al. Global, regional, and National prevalence of adult overweight and obesity, 1990\u20132021, with forecasts to 2050: a forecasting study for the global burden of disease study 2021. Lancet. 2025;405:813\u201338.","journal-title":"Lancet"},{"key":"3948_CR18","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1056\/NEJMra2200869","volume":"386","author":"FA Sinicrope","year":"2022","unstructured":"Sinicrope FA. Increasing incidence of Early-Onset colorectal Cancer. N Engl J Med. 2022;386:1547\u201358.","journal-title":"N Engl J Med"},{"key":"3948_CR19","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1053\/j.gastro.2019.07.055","volume":"158","author":"EM Stoffel","year":"2020","unstructured":"Stoffel EM, Murphy CC. Epidemiology and mechanisms of the increasing incidence of Colon and rectal cancers in young adults. Gastroenterology. 2020;158:341\u201353.","journal-title":"Gastroenterology"},{"key":"3948_CR20","doi-asserted-by":"publisher","first-page":"2337","DOI":"10.1016\/S0140-6736(21)01169-7","volume":"397","author":"MB Reitsma","year":"2021","unstructured":"Reitsma MB, Kendrick PJ, Ababneh E, Abbafati C, Abbasi-Kangevari M, Abdoli A, et al. Spatial, Temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990\u20132019: a systematic analysis from the global burden of disease study 2019. Lancet. 2021;397:2337\u201360.","journal-title":"Lancet"},{"key":"3948_CR21","doi-asserted-by":"publisher","unstructured":"GBD2020AC. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the global burden of disease study 2020. Lancet. 2022;400(10347):185\u2013235. https:\/\/doi.org\/10.1016\/S0140-6736(22)00847-9. Erratum in: Lancet. 2022;400(10349):358.","DOI":"10.1016\/S0140-6736(22)00847-9"},{"key":"3948_CR22","doi-asserted-by":"crossref","unstructured":"Li X, Hur J, Zhang Y, Song M, Smith-Warner SA, Liang L et al. Drinking pattern and time lag of alcohol consumption with colorectal cancer risk in US men and women. JNCI: J Natl Cancer Inst. 2024:djae330.","DOI":"10.1093\/jnci\/djae330"},{"key":"3948_CR23","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1038\/s41416-023-02351-6","volume":"129","author":"F Safizadeh","year":"2023","unstructured":"Safizadeh F, Mandic M, Pulte D, Niedermaier T, Hoffmeister M, Brenner H. The underestimated impact of excess body weight on colorectal cancer risk: evidence from the UK biobank cohort. Br J Cancer. 2023;129:829\u201337.","journal-title":"Br J Cancer"},{"key":"3948_CR24","doi-asserted-by":"publisher","first-page":"djv210","DOI":"10.1093\/jnci\/djv210","volume":"107","author":"N Murphy","year":"2015","unstructured":"Murphy N, Strickler HD, Stanczyk FZ, Xue X, Wassertheil-Smoller S, Rohan TE, et al. A prospective evaluation of endogenous sex hormone levels and colorectal Cancer risk in postmenopausal women. JNCIJ. 2015;107:djv210.","journal-title":"JNCIJ"},{"key":"3948_CR25","doi-asserted-by":"publisher","first-page":"4588","DOI":"10.1210\/jc.2017-01474","volume":"102","author":"N Hetem\u00e4ki","year":"2017","unstructured":"Hetem\u00e4ki N, Savolainen-Peltonen H, Tikkanen MJ, Wang F, Paatela H, H\u00e4m\u00e4l\u00e4inen E, et al. Estrogen metabolism in abdominal subcutaneous and visceral adipose tissue in postmenopausal women. J Clin Endocrinol Metab. 2017;102:4588\u201395.","journal-title":"J Clin Endocrinol Metab"},{"key":"3948_CR26","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/obr.12282","volume":"16","author":"DM Kelly","year":"2015","unstructured":"Kelly DM, Jones TH. Testosterone and obesity. Obes Rev. 2015;16:581\u2013606.","journal-title":"Obes Rev"},{"key":"3948_CR27","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1016\/j.cgh.2012.11.012","volume":"11","author":"JH Lin","year":"2013","unstructured":"Lin JH, Zhang SM, Rexrode KM, Manson JE, Chan AT, Wu K, et al. Association between sex hormones and colorectal Cancer risk in men and women. Clin Gastroenterol Hepatol. 2013;11:419\u2013e4241.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"3948_CR28","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/2042-6410-3-13","volume":"3","author":"K Karastergiou","year":"2012","unstructured":"Karastergiou K, Smith SR, Greenberg AS, Fried SK. Sex differences in human adipose tissues - the biology of Pear shape. Biol Sex Differ. 2012;3:13.","journal-title":"Biol Sex Differ"},{"key":"3948_CR29","unstructured":"Parra S, Boonpor J, Lynskey N, Araya C, Ho F, Pell JP et al. Association between visceral adiposity index and cancer risk in the UK Biobank cohort."},{"key":"3948_CR30","unstructured":"Wang Y. Health policy and public health implications of obesity in China."}],"container-title":["BMC Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-03948-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12876-025-03948-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12876-025-03948-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T13:13:34Z","timestamp":1746191614000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgastroenterol.biomedcentral.com\/articles\/10.1186\/s12876-025-03948-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,2]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3948"],"URL":"https:\/\/doi.org\/10.1186\/s12876-025-03948-2","relation":{},"ISSN":["1471-230X"],"issn-type":[{"value":"1471-230X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,2]]},"assertion":[{"value":"12 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"An ethics approval and the consent to participate were not necessary.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"332"}}