Colorectal Cancer in the Context of Nutrition Transition and Urbanization: A Public Health Systems Perspective

Colorectal cancer (CRC) is increasingly observed among younger populations and in regions undergoing socioeconomic and nutritional transitions. This paper explores colorectal cancer from a public health systems perspective, emphasizing structural determinants beyond individual lifestyle factors. Changing dietary patterns driven by globalization, urbanization, and food system transformation have increased exposure to risk factors such as ultra-processed foods, red and processed meats, and sedentary lifestyles. Biological mechanisms including gut microbiota alteration, chronic inflammation, and metabolic dysfunction contribute to carcinogenesis; however, these mechanisms are strongly influenced by broader social and environmental contexts. Current health systems remain largely treatment-oriented, resulting in delayed diagnoses and limited preventive impact. The paper discusses governance-related approaches including nutrition policy reform, community-based prevention strategies, and integration of screening within primary healthcare systems. A prevention-centered model addressing food environments, urban planning, and health governance is proposed as a sustainable approach to reducing future CRC burden. The study highlights the need for multisectoral collaboration to align policy, healthcare, and social systems toward population-level prevention.