Temporal Trends of Colorectal Cancer Burden in India: A Nationwide and State‐Level Analysis

INTRODUCTION: Colorectal cancer (CRC) ranks third among cancers globally, posing a significant public health issue. This study aimed to analyze CRC incidence, mortality, and risk factors across India from 1990 to 2021 using data from the Global Burden of Disease (GBD) 2021 study. METHODS: We utilized GBD 2021 data, analyzing age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), and annual percentage changes (APC) for CRC across India's 31 states. Statistical modeling, including two sample t-tests, was done. RESULTS: In 2021, India reported 69,409 CRC cases (ASIR: 5.69 per 100,000) and 54,018 deaths (ASDR: 4.60 per 100,000). Both ASIR and ASDR showed increases from 1990 to 2021, highest in adults aged 85+, although these trends were not statistically significant. Mizoram reported the highest incidence rate. Behavioral risks accounted for the largest proportion of CRC deaths (38.85% [95% UI: 24.71-50.32]), particularly diets low in milk (19.16% [95% UI: 5.28-30.72]). High BMI contributed to 4.17% of CRC deaths and showed the highest increase from 1990 to 2021 (+127.47%). CONCLUSION: The rising incidence and mortality of CRC in India highlight the need for targeted public health interventions emphasizing dietary changes, improved screening, and healthcare infrastructure.