Background: Colorectal cancer (CRC) is a common malignancy with nearly 2 million new cases documented in 2020. There were approximately 152,810 new cases of CRC in 2024 emphasizing a need for ongoing preventive research. This study evaluated the relationships between CRC diagnosis and disease risk factors. Current literature provides information about risk factors, however there are gaps in knowledge about factor interactions. This study aims to address these gaps to guide by exploring potential interactions that could increase CRC risk.

Methods: Using National Health and Nutrition Examination Survey (NHANES) data from 2013 to 2023, a secondary data analysis explore the associations between previously identified CRC risk factors and a CRC diagnosis.

Results: Major findings showed that individuals who identified as ‘Other’ race were most likely to have CRC. Study findings supported prior research associations between education level, race/ethnicity, diet, body composition, alcohol consumption, and CRC diagnosis. Additionally, education level mediated the relationship between race/ethnicity and CRC diagnosis. There was a significant interaction between race/ethnicity and waist to height ratio (WHR) with non-Hispanic Asians (NHAs) with an increased WHR the highest likelihood of CRC diagnosis.

Conclusions: Enhanced longitudinal data collection among diverse populations is warranted to guide intervention work on CRC incidence reduction, particularly among high-risk groups.