Colorectal (CRC) is an important public health problem. Worldwide, CRC was the second leading cause of cancer-related disability-adjusted life years (DALYs) for both sexes combined in 2019, accounting for approximately 2.17 million new cases and 1.09 million deaths and resulting in an estimated disease burden of 24.2 million DALYs (95.6% years of life lost and 4.4% years of healthy life lost due to disability). In general, CRC incidence rates show a strong positive gradient with social development index (SDI). Although CRC incidence rates remained stable in recent years and mortality rates mostly decreased in high SDI countries, several low SDI and middle SDI countries showed increases in age-standardized CRC incidence rates [1].The increased incidence of lifestyle-related illnesses, including CRC, is one of the clearest indicators of disease transition within countries undergoing socio-economic development, resulting from the adoption of westernized lifestyles, characterized by an unhealthy diet (low in fruits and vegetables and high in red and/or processed meat), sedentary behavior, alcohol intake and smoking [2,3]. Given that these economic transitions are underway, coupled with growth in populations and increasing life expectancy, the number of persons newly diagnosed with CRC, and the number of CRC-related deaths will continue to increase [1].

In contrast to low and middle SDI countries, in recent years, CRC incidence and mortality show a decrease, particularly among individuals older than aged 50 years, in high-SDI regions and countries. The increased availability of health care resources, favouring a higher utilization of curative surgery, chemotherapy and radiotherapy [[4], [5], [6]], together with improvements in patient management, resulting from closer adherence to guideline recommendations, likely contributed to the decline of CRC mortality. However, the diffusion of screening is a key determinant of CRC incidence and mortality. The largest declines were seen in countries with well-established and long-standing screening programs, in particular among individuals older than 50 years, targeted by screening interventions [1,7]. On the other hand, CRC incidence remained stable or increased in countries that had not introduced large scale screening programs [7]. As long as stage at diagnosis remains the main determinant of survival, access to appropriate, high-quality screening can provide a crucial contribution to improving CRC outcomes and reducing CRC burden.