Original Article

Global Research Trends on Colorectal Cancer (2014-2023): A Scientometric and Visualized Study

Cite this article as: Menbari Oskouie I, Alemi H, Khavandgar N, Mardani-Fard HA, AleTaha A, Mousavian AH, et al. Global research trends on colorectal cancer (2014-2023): a scientometric and visualized study. Arch Iran Med. 2024;27(10):563-572. doi: 10.34172/aim.31944

Introduction

Colorectal cancer (CRC) is thought to be among the most prevalent types of cancer globally, with one to two million diagnosed each year. As a result, CRC is the third most prevalent cancer, with only lung, liver, and stomach cancers having higher rates of death. CRC ranks fourth in terms of causing cancer-related fatalities, resulting in 700 000 fatalities annually.¹ From 1990 to 2012, there was a yearly increase in the occurrence of CRC, with Western countries accounting for 55% of the cases.

Similar to other cancers, specific gene mutations are believed to contribute to the development of CRC. These mutations can occur in oncogenes, tumor suppressor genes, and genes involved in DNA repair mechanisms. Mutations are classified into three groups based on their origin (sporadic, inherited, and familial groups). Nevertheless, around 70% of CRC instances progress through a defined series of genetic mutations, resulting in the development of adenomas and, ultimately, carcinoma. Inherited forms of cancer contribute to just 5% of all CRC cases.²

Age is a significant risk factor for CRC. The incidence of CRC before the age of 50 is rare, excluding inherited cases. However, the chance of developing CRC rises significantly after this age.³ Additionally, there are other permanent risk factors, such as a prior history of CRC or inflammatory bowel disease. Individuals with ulcerative colitis face a 3.7% increased risk of CRC, whereas those with Crohn’s disease have a 2.5% higher risk.^4,5 Moderate physical activities have been shown to improve metabolic rates, gut motility, and long-term metabolic efficiency while reducing blood pressure.⁶ Smoking and alcohol consumption are also considered risk factors.⁷

Currently, the primary treatment for CRC involves a comprehensive approach that considers both tumor-specific (e.g., metastasis, tumor growth rate, and biochemical markers) and patient-specific (e.g., health conditions and prognosis) factors.

Scientometric and bibliometric analyses employ statistical tools to examine scientific publications. The realm of medical research has experienced a rise in scientometric studies owing to an increase in publication volume.^8-10 Despite being a leading cause of mortality and its rising occurrence among the younger population, adversely impacting patient life quality, CRC has not been extensively explored through scientometric analysis. Accordingly, this study seeks to evaluate scientific articles on CRC from 2014 to 2023, using a combination of scientometric and statistical techniques.

Materials and Methods

The bibliographic information concerning CRC research was gathered from Scopus, a leading database for scholarly articles.¹¹ The dataset compilation for this study was finalized on December 31, 2023. The collection process involved searching titles, abstracts, and keywords of publications from 2014 to 2023, based on predefined search criteria detailed in Supplementary file 1, resulting in a total of 200,365 records.

The assembled reference database included comprehensive bibliographic data such as authors, publication titles, publication years, sources, volumes, issues, page numbers, affiliations, abstracts, keywords (both author-defined and indexed), references, document types, and more, which were subsequently processed through scientometric analysis.

The statistical description and visualization of the data were performed using Microsoft Office Excel 2019 (Microsoft, Redmond, WA, USA). For more in-depth scientometric insights into the progression within these fields of research, the study engaged VOSviewer (version 1.6.16), a software known for its ability to visualize academic and scientific networks.^12,13 This includes the representation of intricate relationships among authors, journals, collaborating nations, and citation patterns. VOSviewer also incorporates text mining to extract significant noun phrases from titles and abstracts, facilitating the creation of networks, clusters, and heatmaps to showcase research trends and connections.¹²

Results

Overview of the Included Publications

The literature review in the Scopus database yielded 200,385 publications in the title-abstract-keyword fields related to CRC published between 2014 and 2023. The most popular subject areas of these publications were medicine (n = 149 432, 74.6%), biochemistry (n = 73 686, 36.8%), and pharmacology (n = 17 604, 8.8%), the details of which are shown in Figure 1A. The most frequent article types were original articles (n = 147 337, 73.5%), review articles (n = 29 265, 14.6%), and letters (n = 6052, 3.0%). The remaining publications were the other types of publications (note, editorial, book chapter, conference paper, erratum, short survey, retracted articles, conference review, book, and data paper), the data of which are provided in Figure 1B. Figure 1C likely depicts the distribution of published articles across different years. This visualization provides valuable insights into the trends and volume of research publications over time in the relevant field. In 2023, 24,118 articles were published, followed by 25 492 in 2022 and 25,131 in 2021.

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Figure 1.

Number of Colorectal Cancer Publications From 2014 to 2023 in Different Subject Areas (1A), Article Types (1B), and Each Year (1C)

Figure 1.

Number of Colorectal Cancer Publications From 2014 to 2023 in Different Subject Areas (1A), Article Types (1B), and Each Year (1C)

Active Languages

The top 10 most frequent languages on CRC between 2014 and 2023 were English (n = 188 290, 94.0%), Chinese (n = 5063, 2.5%), Japanese (n = 2168, 1.15%), German (n = 1570, 0.78%), Spanish (n = 1153, 0.58%), French (n = 1043, 0.52%), Russian (n = 103, 0.51%), Czech (n = 265, 0.13%), Portuguese (n = 202, 0.10%), and Persian (n = 137, 0.07%).

Active Countries

Figure 2 illustrates the contribution of various countries to research on CRC from 2014 to 2023. These data can offer insights into the global landscape of CRC research and highlight the countries that are actively involved in studying this disease. The countries that ranked in the top 10 based on the highest number of published articles were China (n = 46 999), the USA (n = 46 027), Japan (n = 14 558), the UK (n = 12 596), Italy (n = 11 721), Germany (n = 10 334), South Korea (8380), France (n = 7540), Spain (n = 7228), and the Netherlands (n = 6451). Related data are presented in Table 1.

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Figure 2.

Number of Articles on Colorectal Cancer Produced by Different Countries From 2014 to 2023

Figure 2.

Number of Articles on Colorectal Cancer Produced by Different Countries From 2014 to 2023

From the 160 countries that published studies on CRC, 135 met the criteria for inclusion in the clustering analysis (Figure 3A) by producing a minimum of ten articles and engaging in international author collaborations. The clustering analysis classified the countries into five distinct clusters denoted by colors (Cluster 1: red, Cluster 2: green, Cluster 3: blue, Cluster 4: yellow, and Cluster 5: purple). Moreover, the total link strength scores, reflecting the level of collaboration between countries, were computed. Figure 3C displays the international collaboration density map based on these scores.

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Figure 3.

Analysis of Countries: Country Co-authorship Network Visualization Map (3A) and Country Co-authorship Density Visualization Map (3B)

Figure 3.

Analysis of Countries: Country Co-authorship Network Visualization Map (3A) and Country Co-authorship Density Visualization Map (3B)

Correlation Analysis

A strong and statistically significant positive correlation was observed between the number of articles published by countries on the CRC and their gross domestic product (GDP; r = 0.961, P < 0.001). Conversely, there was no notable correlation found between the number of articles produced by countries on CRC and their human development index or GDP per capita (P = 0.867 and P = 0.716, respectively).

Active Authors

The top 10 most active authors on CRC between 2014 and 2023 were Brenner (n = 448), Chan (n = 364), Hoffmeister (n = 309), Dekker (n = 289), Ogino (n = 284), Tanis (n = 274), Ishihara (n = 269), Giovannucci (n = 267), Lenz (n = 255), and Doki (n = 251) (Figure 4A and Table 2).

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Figure 4.

Analysis of Authors: Number of Articles on CRC Produced by the 25 Most Active Authors of Colorectal Cancer(4A) and Author Co-authorship Network Visualization Map (4B)

Figure 4.

Analysis of Authors: Number of Articles on CRC Produced by the 25 Most Active Authors of Colorectal Cancer(4A) and Author Co-authorship Network Visualization Map (4B)

The clustering analysis included 160 authors who had published a minimum of 110 articles on CRC and had engaged in international collaboration among their co-authors (Figure 4B). This analysis led to the identification of ten distinct clusters associated with international collaboration.

Active Institutions

The top 10 institutions that generated the most volume of articles on CRC between 2014 and 2023 were the Ministry of Education of the People’s Republic of China (n = 3094), Harvard Medical School (n = 2971), the University of Texas MD Anderson Cancer Center (n = 2653), Memorial Sloan-Kettering Cancer Center (n = 2106), and Inserm (n = 2103). The remaining institutions were Fudan University (n = 1932), Chinese Academy of Medical Sciences and Peking Union Medical College (n = 1906), German Cancer Research Center (n = 1,883), Sun Yat-Sen University (n = 1686), and Brigham and Women’s Hospital (n = 1660) (Figure 5A).

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Figure 5.

Number of Articles on Colorectal Cancer Produced by the 25 Most Active Institutions (5A) and Journals (5B)

Figure 5.

Number of Articles on Colorectal Cancer Produced by the 25 Most Active Institutions (5A) and Journals (5B)

Active Journals

The top 116 journals published 300 or more articles on CRC between 2014 and 2023. The top 10 journals that printed the most significant amount of articles included Cancers (n = 3,006), Frontiers in Oncology (n = 2,814), Oncotarget (n = 2431), PloS One (n = 2267), colorectal disease (n = 2053), and International Journal of Molecular Sciences (n = 1907). The remaining journals were Scientific Reports (n = 1823), BMC Cancer (n = 1592), International Journal of Colorectal Disease (n = 1567), and Annals of Surgical Oncology (n = 1553) (Figure 5B).

Citation Analysis

Out of the 200 385 articles on CRC, Table 3 lists the top 25 articles with the highest total citations. The average number of citations received per year by these articles is provided in the last column of Table 2.

Trend Topics

The most frequent words in CRC articles between 2014 and 2023 were human (n = 172 913), humans (n = 132 323), article (n = 115 629), CRC (n = 88 577), female (n = 85 599), and male (n = 84 347). Among these keywords, 160 were used in at least 6,600 different articles (Table 4). The most frequent author keywords were CRC (n = 6664), cancer (n = 1768), rectal cancer (n = 1456), colon cancer (n = 1352), prognosis (n = 1064), immunotherapy (n = 768), tumor microenvironment (n = 552), metastasis (n = 480), apoptosis (n = 472), chemotherapy (n = 440), and survival (n = 438).

Figure 6 shows the cluster network visualization map presenting the outcomes of the cluster analysis among these keywords.

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Figure 6.

Network Visualization Map: Most Frequent Words (6A) and Most Frequent Author Keywords (6B)

Figure 6.

Network Visualization Map: Most Frequent Words (6A) and Most Frequent Author Keywords (6B)

Discussion

The review of article distribution related to CRC from 2014 to 2023 showed that, on average, 16 771 articles were published annually from 2014 to 2018 (range: 15 867 to 17 659). From 2019 to 2023, the yearly average of published articles rose to 23 324 (range: 19 689 to 25 492). In assessing the contributions by country, 16 of the 20 leading countries in CRC research were developed nations. Only four out of the top 20 countries (i.e., India, Iran, Taiwan, and Turkey) were classified as developing. It was apparent among the countries most active in CRC studies that there exists a significant association between a country’s research output and its GDP. This linkage implies that a country’s economic size and level of development predominantly determine its productivity in publishing CRC research.^14,15

The visualization of collaboration intensity through a density map, based on the total collaboration score among countries, highlighted the United States, England, Germany, Italy, France, the Netherlands, Spain, Australia, China, Sweden, Japan, and Canada as the countries engaging in the highest levels of partnership.

Further examination of co-authorship networks for CRC research pointed out the crucial influence of geographic proximity on article production. The most collaborative clusters were identified as Canada and the United States; a group comprising China, Hong Kong, Macao, Singapore, and Taiwan; a European cluster with Austria, Belgium, France, Germany, Luxembourg, the Netherlands, and the United Kingdom; in addition, an Asian-Middle Eastern cluster included India, Indonesia, Iran, Iraq, Lebanon, Qatar, Saudi Arabia, South Korea, Thailand, and the United Arab Emirates.

The leading journals for CRC research, ranked by the volume of articles published, included Cancers with 3006 articles, followed by Frontiers in Oncology (2814 articles), Oncotarget (2431), PLoS One (2267), Colorectal Disease (2053), International Journal of Molecular Sciences (1907), Scientific Reports (1823), and BMC Cancer (1592). The other journals were the International Journal of Colorectal Disease (1567) and the Annals of Surgical Oncology (1553). Researchers dedicated to CRC studies are advised to consider these journals for publishing their work.

In terms of citations, the most cited CRC study was “Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries” by Bray et al in the Cancer Journal for Clinicians,¹⁶ followed by “Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries” by Sung et al, also in the same journal.¹⁴ The third most cited was “Global cancer statistics” by Torre et al, published in the Cancer Journal for Clinicians.¹⁷ It is recommended that those interested in CRC research consult these highly influential publications.

This study is the latest bibliometric analysis on CRC, highlighting its novelty and significance. Previous notable works included those conducted by Wrafter et al, Darroudi et al, and Jin et al.^18-20 Wrafter et al identified the top 100 most-cited CRC articles,¹⁸ and Darroudi et al and Jin et al performed bibliometric analyses on CRC treatment and the management of liver metastasis in CRC, respectively.^19,20 Our literature review’s scope was bound by the choice of the Scopus database, which, while comprehensive, may omit some research found in the PubMed database, which lacks citation and co-citation analysis capabilities, and the Web of Science database, which focuses on higher-impact journals.^8-10

Conclusion

A search within the Scopus database revealed a total of 200,385 documents focusing on “CRC” across title, abstract, and keyword fields from 2014 to 2023, with China leading in publication numbers (46 674 articles) and its Ministry of Education being the most prolific institution. The five most common keywords among these publications were ‘CRC’, ‘cancer’, ‘prognosis’, ‘rectal cancer’, and ‘colon cancer’. It is suggested that more research be performed to explore why CRC incidence rates are on the rise among young and middle-aged individuals. Despite the ongoing global collaborative efforts, there is a call for increased support and research into CRC, particularly in less developed nations. This paper aimed to inform clinicians, researchers, and surgical assistants about the international state of CRC research outcomes.

Supplementary Files

References

1. Forman D, Ferlay J, Stewart BW, Wild CP. The global and regional burden of cancer. In: Stewart BW, Wild CP, eds. World Cancer Report 2014. Lyon: International Agency for Research on Cancer, World Health Organization; 2014. p. 16-53.
2. Fearon ER, Vogelstein B. A genetic model for colorectal tumorigenesis. Cell 1990; 61(5):759-67. doi: 10.1016/0092-8674(90)90186-i [Crossref] [ Google Scholar]
3. Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008; 58(3):130-60. doi: 10.3322/ca.2007.0018 [Crossref] [ Google Scholar]
4. Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001; 48(4):526-35. doi: 10.1136/gut.48.4.526 [Crossref] [ Google Scholar]
5. Canavan C, Abrams KR, Mayberry J. Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn’s disease. Aliment Pharmacol Ther 2006; 23(8):1097-104. doi: 10.1111/j.1365-2036.2006.02854.x [Crossref] [ Google Scholar]
6. Robertson DJ. ABC of colorectal cancer. Gastroenterology 2012; 143(3):868-9. [ Google Scholar]
7. Pöschl G, Seitz HK. Alcohol and cancer. Alcohol Alcohol 2004; 39(3):155-65. doi: 10.1093/alcalc/agh057 [Crossref] [ Google Scholar]
8. Yıldırım E, Demir E. Comparative bibliometric analysis of fertility preservation. Ann Med Res. 2019,26(8):1622-8. 10.5455/annalsmedres.2019.06.339.
9. Kiraz S, Demir E. Global scientific outputs of schizophrenia publications from 1975 to 2020: a bibliometric analysis. Psychiatr Q 2021; 92(4):1725-44. doi: 10.1007/s11126-021-09937-4 [Crossref] [ Google Scholar]
10. Muslu Ü, Demir E. Development of rhinoplasty: yesterday and today. Med Sci 2019; 23(97):294-301. [ Google Scholar]
11. Mingers J, Leydesdorff L. A review of theory and practice in scientometrics. Eur J Oper Res 2015; 246(1):1-19. doi: 10.1016/j.ejor.2015.04.002 [Crossref] [ Google Scholar]
12. van Eck NJ, Waltman L. Software survey: VOSviewer, a computer program for bibliometric mapping. Scientometrics 2010; 84(2):523-38. doi: 10.1007/s11192-009-0146-3 [Crossref] [ Google Scholar]
13. Waltman L, van Eck NJ, Noyons ECM. A unified approach to mapping and clustering of bibliometric networks. J Informetr 2010; 4(4):629-35. doi: 10.1016/j.joi.2010.07.002 [Crossref] [ Google Scholar]
14. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71(3):209-49. doi: 10.3322/caac.21660 [Crossref] [ Google Scholar]
15. Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol 2019; 16(12):713-32. doi: 10.1038/s41575-019-0189-8 [Crossref] [ Google Scholar]
16. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68(6):394-424. doi: 10.3322/caac.21492 [Crossref] [ Google Scholar]
17. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65(2):87-108. doi: 10.3322/caac.21262 [Crossref] [ Google Scholar]
18. Wrafter PF, Connelly TM, Khan J, Devane L, Kelly J, Joyce WP. The 100 most influential manuscripts in colorectal cancer: A bibliometric analysis. Surgeon 2016; 14(6):327-36. doi: 10.1016/j.surge.2016.03.001 [Crossref] [ Google Scholar]
19. Darroudi M, Gholami M, Rezayi M, Khazaei M. An overview and bibliometric analysis on the colorectal cancer therapy by magnetic functionalized nanoparticles for the responsive and targeted drug delivery. J Nanobiotechnology 2021; 19(1):399. doi: 10.1186/s12951-021-01150-6 [Crossref] [ Google Scholar]
20. Jin B, Wu X, Xu G, Xing J, Wang Y, Yang H. Evolutions of the management of colorectal cancer liver metastasis: a bibliometric analysis. J Cancer 2021; 12(12):3660-70. doi: 10.7150/jca.52842 [Crossref] [ Google Scholar]