Researchers identified a range of risk factors for early-onset colorectal cancer — diagnosed before age 50 — in a recent study published in the journal JNCI Cancer Spectrum.
The incidence of early-onset colorectal cancer (colon and rectal cancers) has been increasing in many countries in recent decades, particularly the United States, Canada, Australia, and Japan, as noted in a press release on the study. In the United States, the rate nearly doubled between 1992 and 2013, rising from 8.6 to 13.1 per 100,000 people. About one in 10 cases of colorectal cancer now occur in people under 50, the age at which screening for colorectal cancer has typically begun. For the latest study, researchers were interested in looking at nongenetic factors linked to the risk of developing colorectal cancer before age 50, using data from 13 different population-based studies in different countries.
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Previous research has shown that a number of dietary factors are linked to the risk for early-onset colorectal cancer, including greater consumption of processed meat, reduced consumption of fruits and vegetables, a higher body-mass index (BMI, a measure of body weight that takes height into account), less physical activity, greater intake of alcohol, smoking, and having diabetes. The latest study, though, is the first large-scale analysis to look how these risks compare with those seen in older people, while also looking at the incidence of colon and rectal cancers separately.
Across all 13 studies included in the analysis, there were 3,767 people with colorectal cancer and 4,049 cancer-free participants (included for comparison) who were under age 50. There were also 23,437 people with colorectal cancer, and 35,311 without cancer, who were age 50 or older. The researchers found that a number of factors increased the risk for early-onset colorectal cancer — including not regularly using nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin (43% higher risk), heavy alcohol consumption (25% higher), abstaining from alcohol (23% higher), greater red meat intake (10% higher), and lower education level (10% higher). For these factors, there was no difference in the risk for early-onset compared with later-onset colorectal cancer.
Variety of factors linked to early-onset colorectal cancer
A number of risk factors, though, were more strongly linked to early-onset compared with later-onset colorectal cancer — including having diabetes and a lower intake of folate, fiber, and calcium. Fiber intake also affected colon and rectal cancers differently, with lower fiber intake linked to a greater risk increase for rectal cancer (30% higher) than for colon cancer (14% higher). Some factors were linked to a higher risk for later-onset colorectal cancer only, including a higher BMI and smoking.
“Targeted identification of those most at risk…is imperative in mitigating the rising burden of this disease,” wrote study author Richard B. Hayes, PhD, in the press release. More research is needed, though, to find out what kinds of interventions are most effective at reducing the risk for colorectal cancer in younger people.
Want to see more recent research on colorectal cancer? Read “Sugary Beverage Intake Linked to Risk for Colorectal Cancer.”
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