Factors such as red meat intake, alcohol consumption, low aspirin use and education level could contribute to a greater risk of an early-onset colorectal cancer diagnosis.
Several risk factors unrelated to genetics may be associated with early-onset colorectal cancer (younger than 50 years of age) including irregular nonsteroidal anti-inflammatory drug use, greater red meat intake, lower education levels, heavy alcohol use and alcohol abstinence, according to data published in JNCI Cancer Spectrum.
Over the past several decades, incidence of colorectal cancer in patients younger than 50 years old has increased, according to the study’s introduction. For example, rates of early-onset colorectal cancer nearly doubled from 1992 to 2013. Researchers aimed to determine whether risk factors for late-onset colorectal cancer are also associated with early-onset colorectal cancer.
The study authors assessed data from 3,767 patients younger than 50 years with colorectal cancer and 4,049 patients without colorectal cancer from the same age group. In addition, they also analyzed data from 23,437 patients aged 50 years and older with colorectal cancer and 35,311 patients without colorectal cancer. All data were obtained from 13 population-based studies.
Early-onset colorectal cancer was associated with irregular use of nonsteroidal anti-inflammatory drugs like aspirin, greater red meat consumption, lower educational levels, alcohol abstinence and heavier alcohol use.
The study authors related this association to major shifts in dietary intake through generations which includes an increase in processed foods and sodas and a decrease in fruit, vegetables and calcium-filled dairy sources.
“These findings may provide the first clues that generational changes in risk-related exposures may contribute to the increases observed internationally in early-onset (colorectal cancer),” the study authors wrote.
The study authors also examined associations of risk factors and early-onset colorectal cancer by subsite. Other risk factors that trended towards association with early-onset rectal cancer included history of diabetes and a lower folate, calcium and dietary fiber consumption.
“In doing so, we provide the first evidence that no use of (nonsteroidal anti-inflammatory drugs), lower intake of dietary fiber and lower intake of folate may be more strongly associated with early-onset cancers of the rectum compared with those of the colon,” the study authors noted.
When comparing risk factors for early-onset and late-onset colorectal cancer, there were no factors that caused a greater risk for one cancer type over the other. Body mass index, smoking and no use of nonsteroidal anti-inflammatory drugs were somewhat suggestive of a greater risk for late-onset colorectal cancer.
“These results present key insights concerning risk factors that contribute to (colorectal cancer) manifestation in younger individuals, providing a basis for identification of those most at risk, which is imperative in mitigating the rising burden of this disease,” the study authors concluded.
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