Spatial Distribution Patterns of Colorectal Cancer Patients in Thailand

Abstract

Colorectal cancer (CRC) is among the leading causes of cancer-related morbidity and mortality worldwide, and it poses a growing public health challenge in Thailand, being the third most prevalent cancer in men and the fourth in women. This study aims to analyze the spatial distribution patterns of CRC cases across Thailand's 77 provinces and explore their correlation with six influencing factors: annual nighttime light (ANTL), smoking behavior, alcohol consumption, processed food consumption, vegetation avoidance, and lack of exercise. Geographic information system (GIS) techniques, cluster analysis, and l regression models, including the Ordinary least Square (OLS), Spatial Lag Model (SLM) and Spatial Error Model (SEM), were employed to uncover these patterns and relationships. The findings reveal substantial clustering of CRC cases in urbanized areas such as Bangkok and surrounding provinces, where high ANTL reflects elevated urbanization, infrastructure, and economic activity. Behavioral factors, including smoking and alcohol consumption, exhibited significant spatial clustering, predominantly in the southern and northeastern regions, respectively. The northeastern region also exhibited hotspots of processed food consumption, while vegetation avoidance rates were notably low across Thailand, reflecting widespread adherence to vegetable-rich diets. Regression analysis highlighted ANTL as the most statistically significant predictor of CRC incidence, underscoring the influence of urbanization and associated lifestyle changes on CRC rates. These results underscore the need for tailored public health interventions that account for the unique spatial dynamics of CRC risk factors. By integrating GIS tools and spatial analysis, public health strategies can target high-risk areas, optimize resource allocation, and promote region-specific lifestyle modifications, thereby improving CRC prevention and outcomes in Thailand.