S625 A Global Wake-Up Call: Age, Gender, and Regional Disparities in Colorectal Cancer Due to Physical Inactivity (1990–2021)

Introduction: Low physical activity (LPA) is a rising global concern, fueled by urbanization, sedentary lifestyles, and reduced physical engagement in daily life. This shift has contributed to the growing burden of chronic diseases, with colorectal cancer (CRC) emerging as one of the leading causes of cancer-related morbidity and mortality. Despite its strong association with modifiable behaviors like LPA, the long-term global impact of LPA on CRC burden—especially across mortality and disability dimensions—remains underexplored. Methods: CRC burden linked to LPA was quantified using GBD 2021 estimates, which integrate global cancer registries and risk-exposure data via the CODEm framework and population attributable fractions. Age-standardized death, YLD, and DALY rates were analyzed across 204 countries from 1990 to 2021. Annual percentage change (APC) was calculated by age, sex, year, and location using log-linear regression. Results: Between 1990 and 2021, CRC deaths attributable to LPA nearly doubled—from 36,496 (95% UI: 23,150–50,771) to 71,475 (44,830–98,195). YLDs rose from 25,010 (14,863–35,949) to 64,261 (38,282–95,890), while YLLs increased from 700,253 (439,760–970,583) to 1,265,427 (781,584–1,736,985). By socio-demographic index (SDI), the highest APC in deaths was observed in middle SDI countries (2.05%), followed by low-middle (1.99%), low (1.21%), high-middle (1.12%), and high SDI regions (0.44%). Regionally, the greatest increase in YLLs occurred in the Eastern Mediterranean (APC: 1.88%), Southeast Asia (1.85%), and Africa (1.49%), with smaller increases in the Western Pacific (1.23%), Americas (0.82%), and Europe (0.2%). Age-wise, the 20–54 year group showed the sharpest rise in unadjusted YLDs (APC: 0.48%), followed by those aged 55+ (0.17%). Men consistently experienced a higher burden than women across all measures—APC in deaths (1.32% vs 0.76%), YLDs (2.09% vs 1.27%), and YLLs (1.11% vs 0.63%). Conclusion: Deaths due to CRC attributable to LPA accounted for 6.84% of all CRC related deaths globally in 2021. The burden of colorectal cancer attributable to low physical activity has risen significantly over the past 3 decades, particularly in middle and low-middle SDI regions, among men, and adults aged 20–54. While mortality and disability have increased globally, sharp regional and demographic disparities underscore the urgent need for targeted, population-specific physical activity interventions and cancer prevention strategies.