Global burden of early-onset colorectal cancer related to alcohol, tobacco, and physical inactivity: evidence from the global burden of disease 2021.

Objective: To investigate global trends in early-onset colorectal cancer attributable to behavioral risk factors (high alcohol use, tobacco, and low physical activity). Methods: Data on early-onset colorectal cancer were obtained from the Global Burden of Disease 2021 database. Epidemiological tendencies were evaluated. Correlation between socio-demographic index and age-standardized rates was evaluated using the Pearson correlation coefficient. Bayesian age-period-cohort models were to predict disease burden by 2050. Results: From 1990 to 2021, the global burden of early-onset colorectal cancer attributable to the three behavioral risk factors declined overall. The most decrease in disease burden caused by tobacco was in the high socio-demographic index regions. The decrease of burden was the most in Europe. Fractions of disease burden attributable to high alcohol use and tobacco were higher in males, whereas the opposite pattern was observed for low physical activity. The disease burden was increased with age, reaching the highest level in individuals aged 45-49 years. In addition, disease burden was positively correlated with socio-demographic index. Projections indicated that by 2050, the disease burdens attributable to high alcohol use and tobacco were expected to decline, while the burden associated with low physical activity was relatively stable. Conclusions: Over the past three decades, the global burden of early-onset colorectal cancer attributable to three behavioral risk factors exhibits an overall downward trend. Targeted prevention and management strategies should particularly focus on individuals aged 45-49.