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Sunday Poster Session

Category: Colon

P0306 - Behavioral Drivers of Colorectal Cancer in High-Income Countries: A 30-Year Epidemiological Analysis

Sunday, October 26, 2025
3:30 PM - 7:00 PM MT
Location: Exhibit Hall
Shivam Kalra, MBBS, MHA1, Jay Patel, MBBS2, Uma Shailendri Rayudu, MBBS3, Deepika Sanapala, MBBS4, Pragathi Munnangi, MBBS5, Venkata Ramana Kaltikala, MBBS6, Bhargav Koyani, MBBS7, Chandana Tummala, MBBS8, Jeel Patel, MBBS9, Shreyaa Rajpal, MBBS10, Hardik Dineshbhai Desai, MBBS11
1Trident Medical Center, North Charleston, SC; 2MGM Medical College, Aurangabad, Maharashtra, India-431003, Aurangabad, Maharashtra, India; 3Gitam institute of medical sciences and research, Guntur, Andhra Pradesh, India; 4Katuri medical college, Gudivada, Andhra Pradesh, India; 5NRI Academy of Medical Sciences, Mangalagiri, Andhra Pradesh, India; 6Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India; 7Saint Francis Hospital, Evanston, Evanston, IL; 8Internal Medicine, Vydehi Institute Of Medical Sciences and Research Centre, Whitefield-560066, Bangalore, Karnataka, India, Bangalore, Karnataka, India; 9Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India; 10Osmania General Hospital and Medical College, Hyderabad, Telangana, India; 11Independent Researcher, Ahmedabad, Gujarat, India

Introduction: Despite advanced health systems, high-income countries (HICs) continue to face a significant and growing burden of colorectal cancer (CRC) linked to modifiable behavioral risk factors. Unhealthy diets, physical inactivity, alcohol consumption, and tobacco use have emerged as key contributors to CRC-related mortality and disability in these regions.

Methods: Using the Global Burden of Disease Study 2021 comparative risk assessment (CRA) framework, we estimated the CRC burden attributable to behavioral risk factors (BRF) across World Bank HICs. Population-attributable fractions (PAFs) were calculated by comparing the distribution of each risk exposure—dietary risk factors (DRF), high alcohol use, low physical activity (LPA), and tobacco use—to theoretical minimum risk exposure levels (TMRELs). These PAFs were applied to CRC deaths, DALYs and YLDs to derive the proportion attributable to behavioral risks. Trends from 1990 to 2021 were assessed using annualized percentage change (APC) in age-standardized rates and absolute counts stratified by age, sex, year and location.

Results: Between 1990 and 2021, CRC deaths attributable to DRF increased from 103,318 (95% UI: 25,119–159,948) to 137,253 (32,702–214,824); due to LPA from 20,527 (13,013–29,079) to 28,547 (17,379–39,314); high alcohol use from 19,750 (14,747–24,815) to 24,435 (18,842–30,108); while tobacco-related deaths declined from 14,082 (8,799–19,376) to 13,206 (7,924–18,684). Western Europe and North America bore the highest burden, but Asia Pacific showed the fastest rise, with APCs of 2.54% (deaths) and 3.02% (YLDs). Age-wise, individuals aged ≥55 experienced increased burden (APC in deaths: +0.34%; DALYs: +0.82%), while those aged 20–54 saw a slight decline in deaths (–0.05%) but a rise in DALYs (+0.5%). Males consistently showed higher burden than females, with APCs for deaths (1.08% vs 0.64%), DALYs (0.75% vs 0.27%), and YLDs (2.16% vs 1.52%).

Discussion:

In 2021, deaths due to BRF accounted for 50.37% of all CRC related deaths in HICs. From 1990 to 2021, the burden of CRC due to BRF rose significantly, driven by DRF, LPA, and alcohol use—especially among males and those aged 55 and above. While tobacco-related deaths declined, rising trends in Asia Pacific and persistent sex disparities underscore the need for targeted, lifestyle-focused interventions.




Figure: Geographical and Behavioral Pattern IN CRC


Figure: CRC Burden by Age Group

Disclosures:
Shivam Kalra indicated no relevant financial relationships.
Jay Patel indicated no relevant financial relationships.
Uma Shailendri Rayudu indicated no relevant financial relationships.
Deepika Sanapala indicated no relevant financial relationships.
Pragathi Munnangi indicated no relevant financial relationships.
Venkata Ramana Kaltikala indicated no relevant financial relationships.
Bhargav Koyani indicated no relevant financial relationships.
Chandana Tummala indicated no relevant financial relationships.
Jeel Patel indicated no relevant financial relationships.
Shreyaa Rajpal indicated no relevant financial relationships.
Hardik Dineshbhai Desai indicated no relevant financial relationships.

Shivam Kalra, MBBS, MHA1, Jay Patel, MBBS2, Uma Shailendri Rayudu, MBBS3, Deepika Sanapala, MBBS4, Pragathi Munnangi, MBBS5, Venkata Ramana Kaltikala, MBBS6, Bhargav Koyani, MBBS7, Chandana Tummala, MBBS8, Jeel Patel, MBBS9, Shreyaa Rajpal, MBBS10, Hardik Dineshbhai Desai, MBBS11. P0306 - Behavioral Drivers of Colorectal Cancer in High-Income Countries: A 30-Year Epidemiological Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.