Several non-modifiable risk factors, such as race, sex and family history all contribute to the development of early-onset colorectal cancer, according to study results.
Peter S. Liang, MD, MPH, of the department of medicine at NYU Langone Health, and colleagues wrote that incidence of CRC is rising among individuals younger than 50 years, and the rate is expected to double in the next decade.
“The reasons for this are unclear, but they likely include a combination of non-modifiable and modifiable risk factors,” they wrote. “Identifying specific risk factors in patients with early-onset CRC may permit risk stratification and targeted screening.”
Researchers compared sociodemographic and medical data of patients who received a CRC diagnosis between age 18 and 49 years (n = 269) with patients who were diagnosed with CRC age 50 years or older (n = 2,802) and cancer-free individuals (n = 1,122). They collected data from all adult patients with a CRC diagnosis at a single tertiary hospital from 2011 to 2017.
Compared with controls, patients with early-onset CRC were more likely to be male (OR = 1.87; 95% CI, 1.39–2.51), have inflammatory bowel disease (3% vs. 0.4%, P < .01) and have a family history of CRC (OR = 8.61; 95% CI, 4.83–15.75). Compared with patients with late-onset CRC, patients with early onset CRC were more likely to be male (OR = 1.44; 95% CI, 1.11–1.87), black (OR = 1.73; 95% CI, 1.08–2.65) or Asian (OR = 2.6; 95% CI, 1.57–4.15) and have IBD (OR = 2.97; 95% CI, 1.16–6.63) or a family history of CRC (OR = 2.87; 95% CI, 1.89–4.25).
Early-onset CRC was more likely than late-onset CRC to be detected in the left colon or rectum (75% vs. 59%, P = .02), and more likely to be detected at a late stage of tumor development (77% vs. 62%, P = .01).
Liang and colleagues wrote that they did not find any links to early-onset CRC with well-established modifiable risk factors, like obesity, smoking and diabetes.
“These data suggest non-modifiable factors should be included in risk prediction models to facilitate targeted screening in individuals under age 50,” they wrote. “Such efforts can be refined as more granular predictors of early-onset CRC, especially early-life exposures that are measurable and readily available in the clinical setting, are identified from future prospective studies.” – by Alex Young
Disclosure s: The authors report no relevant financial disclosures.