S336 The Evolution of Colorectal Cancer Research: A Top-Cited Temporal and Geographic Exploration

Introduction: Colorectal cancer (CRC) is among the most prevalent malignancies worldwide and a leading cause of cancer-related mortality. The expansion of CRC research has paralleled advances in screening, diagnostics, and treatment. However, citation impact and authorship CRC studies remain unequally distributed across countries and institutions. We aim to evaluate global publication trends, citation performance, and geographic disparities among the 1,000 most cited articles on colorectal cancer. Methods: A bibliometric analysis was performed using the Web of Science Core Collection. Initially, a total of 195,656 publications from 1965 to 2024 were identified, of which 54,123 excluded as Meeting Abstract. The 1,000 most cited CRC-related articles were analyzed using the Bibliometrix R package. Key indicators included author productivity, institutional affiliations, source journals, corresponding author countries, and citation impact. Results: The selected 1,000 articles spanned over 5 decades and were published in 170 journals. The United States dominated the field, contributing 415 of the top 1,000 publications (41.5%), followed by the United Kingdom (UK) (94), Germany (59), Italy (45), and Japan (34). These 5 countries accounted for nearly 2-thirds of all high-impact CRC articles. The USA also led in total citations (343,220), followed by the UK (79,028), underscoring their global research influence. Top 3 institutional analysis revealed that top-producing centers included Harvard University, Johns Hopkins University, and MD Anderson Cancer Center. Top publication journals included the Journal of Clinical Oncology (129 articles), New England Journal of Medicine (82), and Lancet Oncology (76), reflecting the clinical and translational focus of CRC research. The most globally cited document was Hurwitz et al. (2004, New England Journal of Medicine), which evaluated bevacizumab in metastatic CRC and accrued 8,524 citations. Low- and middle-income countries were notably underrepresented, with 5.6% of publication, with minimal presence among top-cited works. Conclusion: Highly cited CRC research is disproportionately concentrated in high-income countries. This imbalance underscores the need for broader international collaboration and capacity-building efforts to foster equitable research contributions. Greater engagement from LMICs is essential to improve global understanding of CRC pathophysiology, risk factors, and culturally relevant care strategies.