Objective To analyze the level, trend of colorectal cancer mortality and years of life lost due to colorectal cancer in Wenzhou, Zhejiang province, from 2014 to 2022, and provide evidence for the development of colorectal cancer prevention and control measures.

Methods The mortality data of colorectal cancer in Wenzhou from 2014 to 2022 were collected from Wenzhou Chronic Disease Surveillance and Management Information System for a descriptive analysis. The crude mortality rate, standardized mortality rate, and potential years of life lost (PYLL) were calculated. The annual percentage change (APC) was used to analyze the temporal trends in colorectal cancer mortality, and a grey dynamic model GM (1, 1) was used for the prediction of colorectal cancer mortality.

Results From 2014 to 2022, A total of 11113 deaths of colorectal cancer were reported in Wenzhou, accounting for 9.13% of total cancer deaths and ranking fourth of the leading causes of death. The average crude mortality rate and standardized mortality rate of colorectal cancer were 15.13/100000 and 11.24/100000, respectively. The crude mortality rate showed an increasing trend (APC=4.47%, P<0.001), and the standardized mortality rate was stable (APC=0.97%, P=0.039).The average crude mortality rate and standardized mortality rate in men (18.28/100000 and 13.28/100000) were higher than that in women (11.75/100000 and 8.88/100000) (P<0.05). The mortality rate of colorectal cancer was higher than in urban area than in rural area (χ²=21.569, P<0.001). Age-specific mortality rate for colorectal cancer increased with age (trend χ²=33 278.865, P<0.001), with a significant increase in age group ＞50 years. The highest mortality rate was observed in age group ≥85 years, reaching 182.04/100000. There was no significant change in mortality rate in different age groups over time (P>0.05). The PYLL caused by colorectal cancer deaths was 50895.00 person-years, with a PYLL rate of 0.75‰. The PYLL rate and PYLL were higher in men than in women. The PYLL rate increased with age, and decreased after peaking in age group 60–69 years. It is predicted that the crude mortality rate of colorectal cancer would increase in the following 5 years, reaching 23.30/100000 by 2027.

Conclusion The crude mortality rate of colorectal cancer showed an increasing trend in Wenzhou from 2014 to 2022, and men, middle-aged and elderly individuals and urban residents were at higher risk. In the context of accelerated population aging, the disease burden will become more severe. It is necessary to conduct targeted intervention, promote healthy lifestyle and dietary and strengthen colorectal cancer screening to reducing the morbidity and mortality of colorectal cancer.