# Socioeconomic and Healthcare Indicators and Colorectal Cancer Burden: Analysis of Eurostat and Global Burden of Disease Study 2021 Data

## TL;DR

This study shows how socioeconomic factors and healthcare access affect colorectal cancer disparities in EU countries using data from 2005 to 2021.

## Contribution

The study links CRC burden to healthcare resources and income inequality across EU nations using GBD and Eurostat data.

## Key findings

- Inequality in years lived with disability (YLD) decreased, but disparities in mortality, YLL, and DALY rates increased.
- Higher physician availability and education levels were associated with lower CRC burden.
- Greater income inequality correlated with higher CRC mortality and burden metrics.

## Abstract

Colorectal cancer (CRC) remains a major health and economic challenge across the European Union (EU). This study aimed to examine trends and inequalities in CRC burden and to explore its association with country-level socioeconomic and healthcare indicators across 24 EU member states. CRC burden was measured using age-standardized mortality, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALY) rates, which were obtained from the Global Burden of Disease Study 2021. Socioeconomic and healthcare data were collected from Eurostat between 2005 and 2021. While inequality in YLD rate decreased, disparities in mortality, YLL, and DALY rates increased. Higher numbers of physicians and higher education levels were linked to lower CRC burden, while a greater income inequality was linked to higher burden. These findings emphasize the importance of expanding screening programs, improving healthcare capacity, and reducing social inequalities to address CRC disparities in the EU.

Background/Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide, posing a substantial health and economic burden. Despite advances in screening and treatment, significant socioeconomic and healthcare-related disparities persist across European Union (EU) member states. This study aims to identify trends and inequality in CRC burden over time and to explore the relationship between country-level socioeconomic and healthcare indicators and CRC burden across EU member states. Methods: Age-standardized mortality, years lived with disability (YLD), years of life lost (YLL), and disability-adjusted life years (DALY) rates were extracted from Global Burden of Diseases Study 2021 for 24 EU countries. Socioeconomic and healthcare indicators were extracted from Eurostat between 2005 and 2021. The Gini index was calculated to evaluate CRC-related health inequality, and generalized linear mixed models were used to assess the link between indicators and disease burden. Results: The Gini index for age-standardized YLDs declined from 0.19 to 0.12 between 1990 and 2021, while inequality in YLL (from 0.11 to 0.16), DALY (from 0.11 to 0.15), and mortality rates (from 0.12 to 0.14) increased. The number of practicing physicians (p < 0.05) and higher levels of education (p < 0.001) were related to lower death, DALY, YLD, and YLL rates. Conversely, greater income inequality was linked to higher mortality, DALY, and YLL rates (p < 0.05). Conclusions: Our findings underscore that, in addition to expanding organized screening programs, enhancing physician availability and addressing socioeconomic inequalities are essential for reducing the burden of CRC.