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Background <p>The global incidence of early-onset colorectal cancer (EOCRC) is rising. We compared trends in dietary fiber intake, a key modifiable risk factor, and its attributable EOCRC burden among young adults in China versus globally from 1990 to 2021.</p> Methods <p>Using data from the GDD and GBD 2021 for adults aged 25–49, we analyzed age-standardized mean fiber intake, summary exposure value (SEV) for low intake, and attributable EOCRC mortality and disability-adjusted life years (DALYs). Trends were quantified using the estimated annual percentage change (EAPC).</p> Results <p>Between 1990 and 2018, China’s mean dietary fiber intake increased dramatically from 5.0 to 23.3&#xa0;g/day (EAPC 5.73%), substantially outpacing the global increase (EAPC 1.41%). This led to a profound reversal in risk exposure; China’s SEV for low fiber declined at nearly twice the global rate (EAPC −2.14% vs −1.15%), falling below the global benchmark after 2005. Consequently, the attributable age-standardized mortality rate in China dropped from 0.15 per 100,000 to converge with the global level of 0.05 by 2021 (EAPC −3.81% vs −2.17% globally). Similar rapid declines occurred for DALYs and were more pronounced in women. Favorable epidemiological changes were the primary driver of this reduction.</p> Conclusion <p>China’s success in reducing its EOCRC burden from low dietary fiber highlights nutritional improvement as a potent primary prevention strategy, reinforcing the urgent need to promote fiber-rich diets globally.</p>

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Improving dietary fiber intake is associated with a declining burden of early-onset colorectal cancer: a three-decade comparative analysis in China and globally

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月14日

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  • Guanmin Cui,
  • Kai Jing,
  • Yunxia Li,
  • Jianhua Gu,
  • Fang Li

摘要

Background

The global incidence of early-onset colorectal cancer (EOCRC) is rising. We compared trends in dietary fiber intake, a key modifiable risk factor, and its attributable EOCRC burden among young adults in China versus globally from 1990 to 2021.

Methods

Using data from the GDD and GBD 2021 for adults aged 25–49, we analyzed age-standardized mean fiber intake, summary exposure value (SEV) for low intake, and attributable EOCRC mortality and disability-adjusted life years (DALYs). Trends were quantified using the estimated annual percentage change (EAPC).

Results

Between 1990 and 2018, China’s mean dietary fiber intake increased dramatically from 5.0 to 23.3 g/day (EAPC 5.73%), substantially outpacing the global increase (EAPC 1.41%). This led to a profound reversal in risk exposure; China’s SEV for low fiber declined at nearly twice the global rate (EAPC −2.14% vs −1.15%), falling below the global benchmark after 2005. Consequently, the attributable age-standardized mortality rate in China dropped from 0.15 per 100,000 to converge with the global level of 0.05 by 2021 (EAPC −3.81% vs −2.17% globally). Similar rapid declines occurred for DALYs and were more pronounced in women. Favorable epidemiological changes were the primary driver of this reduction.

Conclusion

China’s success in reducing its EOCRC burden from low dietary fiber highlights nutritional improvement as a potent primary prevention strategy, reinforcing the urgent need to promote fiber-rich diets globally.