Abstract
Background: Cholesterol metabolism is important in colorectal cancer (CRC) pathogenesis, influencing tumorigenesis and therapeutic responses. Despite extensive research, fragmented insights and a lack of systematic analysis hinder the identification of global trends, collaboration networks, and emerging hotspots in this rapidly evolving field. Methods: A bibliometric analysis of 1532 publications (2003-2024) from the Web of Science Core Collection was conducted using VOSviewer, CiteSpace, and R software. Metrics included publication trends, country/institution contributions, author networks, journal influence, keyword co-occurrence, and citation bursts. Results: Global publications exhibited exponential growth, peaking at 114 in 2024. The United States (347 articles, 17,613 citations) and China (316 articles) dominated research output, yet institutional collaboration remained limited. Key journals included PLOS One and Cancer Research. Keyword evolution shifted from "physical activity" and "carcinogenesis" to "cholesterol metabolism," "gut microbiota," and "nanomedicine." Statins showed preventive potential but raised concerns with prolonged use. Mechanistic insights highlighted nanoparticle-driven therapies as promising strategies to enhance chemosensitivity and reverse immunosuppression. Conclusion: This inaugural comprehensive bibliometric analysis delineates the current research landscape of cholesterol in CRC, with particular emphasis on elucidating metabolic reprogramming mechanisms and fostering cross-disciplinary convergence. Future priorities include validating statins' efficacy via randomized trials, leveraging multiomics for personalized therapies, and fostering global collaboration to address geographic disparities and translational challenges.