US State-Level risk factor changes related to early-onset colorectal cancer

Longitudinal: State-level early-onset (ages 20-49) colorectal cancer (CRC) incidence (CDC WONDER) and Behavioral Risk Factor Surveillance System (BRFSS) behavioral/clinical prevalence data were each restricted to the 6 years with matching survey coverage (2012, 2014, 2016, 2018, 2020, and 2022) and joined by state and year, resulting in 306 state-year observations. EXPLANA was run on a complete dataset with no missing values to remove imputation bias. 25 variables were retained on obesity, diet, physical activity, alcohol use, smoking, diabetes, and general health, while excluding colorectal screening variables, which were inconsistently collected. EXPLANA was then run with a random effect of state to identify factors related to crude early-onset CRC incidence rate per 100,000 population.