Diabetes and socioeconomic status as key risk factors for colorectal cancer in the pashtun population: a case-control study.

BACKGROUND

Colorectal cancer (CRC) is a major global health burden, with rising incidence in South Asia and significant variation across ethnic and socioeconomic groups. Despite this growing concern, CRC risk factors remain understudied in the Pashtun population of Pakistan. Given the potential influence of metabolic and socioeconomic determinants, this study aimed to identify key CRC risk factors within this underserved community.

METHODS

A case–control study was performed on Pashtun individuals registered for colonoscopy or surgery in tertiary care hospitals in Peshawar from April 2023 till March 2025. A sample of 51 cases and 51 controls was selected through simple random sampling. Data on CRC risk factors, including diabetes mellitus (DM), smoking, lifestyle, and family history, were collected via a validated questionnaire. Statistical analysis included chi-squared tests; multiple regression analysis, and correlation analysis, were used.

RESULTS

The study included 51 cases and 51 controls to explore risk factors for colorectal cancer (CRC). Results indicated that a higher monthly income was linked to a reduced risk of CRC (p = 0.03). Notably, the presence of diabetes mellitus (DM) prior to CRC diagnosis was significantly associated with an increased risk (p = 0.002), a finding further supported by multiple regression analysis. Correlation analysis found weak and non-significant links between CRC and other factors, such as exercise frequency, regular walking distance, HbA1c levels, smoking status, and family history of cancer.

CONCLUSION

These findings highlight the significant role of socioeconomic status and diabetes in CRC development among the Pashtun population. While certain factors like smoking and family history did not show significant associations, the study underscores the need for targeted preventive strategies to reduce the CRC burden. Further research is necessary to elucidate these relationships comprehensively.