Higher red meat intake, lower educational attainment, and heavier alcohol use are associated with an increase in colorectal cancer for patients under 50 years of age, according to a study published in JNCI Cancer Spectrum. Incidence rates of early-onset colorectal cancer in the United States have increased from 8.6 to 13.1 per 100,000 between 1992 and 2013, with most of this increase attributable to early-onset cancers of the rectum. Approximately 10% of colorectal cancer diagnoses in the United States occur in individuals under 50 years of age.
The researchers used data aggregated from 13 population-based studies, examining 3767 colorectal cancer cases in patients under 50 years of age with 4049 controls, and 23,437 cases with 35,311 controls in individuals 50 years of age or older. The study found early-onset colorectal cancer was associated with not regularly using aspirins, greater red meat intake, lower educational attainment, heavier alcohol use as well as alcohol abstinence. Researchers also found that lower total fiber intake was linked more strongly to rectal than colon cancer.
Previous research has outlined potential risk factors for early-onset colorectal cancer, including greater consumption of processed meat, reduced consumption of vegetables and citrus fruit, greater body mass index (BMI), sedentary lifestyles, greater alcohol use, smoking, reduced aspirin use, and diabetes. According to the investigators, this is the first study to perform a comprehensive, large-scale evaluation comparing the magnitude of these risks with those for late-onset colorectal cancer and to assess whether the risks for early-onset colorectal cancer correlate with specific types of colorectal cancer.
Common colorectal cancer risk factors trended toward an association with early-onset colorectal cancer, including history of diabetes and lower folate, dietary fiber, and calcium intake. However, neither BMI nor smoking were risk factors in the early-onset group in contrast to the late-onset group.
“This first large-scale study of non-genetic risk factors for early-onset colorectal cancer is providing the initial basis for targeted identification of those most at risk, which is imperative in mitigating the rising burden of this disease,” said Richard Hayes, DDS, MPH, PhD, professor of population health and environmental medicine at NYU Langone Health, in a press release.
Red meat intake, poor education linked to colorectal cancer [news release]. EurekAlert; May 20, 2021. Accessed May 20, 2021. https://www.eurekalert.org/pub_releases/2021-05/oupu-rmi051321.php