Jul 2026· Cancer Causes and Control· Vol 37· 0 citations· 42 references
Medicine
TL;DR
Alcohol consumption, consuming the most alcohol in one’s teens/twenties, binge drinking, having Lynch syndrome, and pre-diagnostic CRC symptoms were more associated with EOCRC than LOCRC.
Abstract
Examine which demographic, lifestyle, and clinical risk factors differ between patients with early-onset colorectal cancers (EOCRC) compared to late-onset colorectal cancers (LOCRC). We conducted a case-case comparison of risk factors and symptoms for EOCRC and LOCRC, utilizing the Ohio Colorectal Cancer Prevention Initiative (OCCPI) data, a statewide study of newly diagnosed CRC among Ohio residents, aged 20–92 years. Unconditional logistic regression (odds ratios (OR) and 95% confidence intervals (CI)) was used to compare risk factors by age-at-diagnoses; those diagnosed < 50 years (EOCRC, N = 288) compared to those diagnosed ≥ 50 years (LOCRC, N = 1,018), adjusting for sex, race/ethnicity, education, smoking status, and family history of CRC. Compared to LOCRC, EOCRC cases had higher odds of ever consuming alcohol (OR = 2.47, CI: 1.55–3.91), consuming more alcohol in their teens/twenties than in other decades (OR = 1.85, CI: 1.36–2.51), and binge drinking (OR = 3.15, CI: 2.31–4.30). EOCRC cases were more likely to have Lynch syndrome (OR = 4.61, CI: 2.72–7.84), and report experiencing pre-diagnostic CRC symptoms (OR = 6.08, CI: 3.77–9.82), including blood in stool (52.3 vs. 30.7%), change in bowel habits (37.2 vs. 19.8%), and bowel obstruction (13.9 vs. 7.7%). Birth weight, inflammatory bowel disease, irritable bowel syndrome, and sex did not differ by age-at-diagnosis. However, when birthweight was compared between the youngest EOCRC to the oldest LOCRC cases (< 40 vs. ≥ 65 years), odds of birthweight of < 6lbs was higher in the youngest cases (OR: 2.15, CI: 0.95–4.87). Alcohol consumption, consuming the most alcohol in one’s teens/twenties, binge drinking, having Lynch syndrome, and pre-diagnostic CRC symptoms were more associated with EOCRC than LOCRC.
Background The incidence of early-onset colorectal cancer (EOCRC), defined as diagnosis before age 50, is rising despite declining overall colorectal cancer (CRC) rates. EOCRC presents distinct clinical challenges, with emerging associations to obesity and sociodemographic disparities. This study compares hospitalization trends, inpatient outcomes, and sociodemographics in EOCRC vs. late-onset CRC (LOCRC). Methods Using the National Inpatient Sample (NIS) (2016–2020), we identified hospitalizations with a primary diagnosis of CRC. Patients were categorized from a hospital-based classification of EOCRC (<50 years) or LOCRC (≥50 years). Multivariate logistic regression assessed associations between body mass index (BMI), demographics, and outcomes including inpatient mortality, length of stay (LOS), and chemotherapy use. Results Among 246,231 CRC hospitalizations, 13.7% (n=33,662) were EOCRC. Compared to LOCRC, EOCRC patients were more likely to be female [odds ratio (OR): 1.09], Black (OR: 1.17), Hispanic (OR: 1.56), or Asian (OR: 1.29), and more often covered by Medicaid, private insurance, or have no coverage. EOCRC patients had higher rates of tobacco use disorder (OR: 1.26) and depression (OR: 1.13), but lower prevalence of diabetes, coronary artery disease (CAD), and alcohol use disorder. EOCRC hospitalizations had lower inpatient mortality (OR: 0.649). Inpatient chemotherapy was more common in EOCRC (OR: 1.78). Obesity was positively associated with EOCRC for BMI 30–39 (OR: 1.07) and BMI ≥40 (OR: 1.50), while LOCRC showed inverse associations for the same BMI groups. Conclusions EOCRC is associated with unique demographic and clinical profiles when compared to LOCRC, highlighting disparities by race, insurance status, and comorbidities. The higher rate of inpatient chemotherapy use in EOCRC warrants further study to evaluate its clinical necessity and outcomes. These findings reinforce the need for targeted screening and inpatient care strategies for younger and underserved patient populations.
Manali Shah, Ravi Upadhyay, Lawanya Singh et al.· Journal of Gastrointestinal...· 0 citations
An elevated risk of early-onset rectal cancer was suggested in individuals with high birth weight in a nested case-control study that evaluated the association between high birth weight and eoCRC in a nested case-control study.
Amrita Mukherjee, Lan-Fang Xu, D. Getahun et al.· Cancer Epidemiology, Biomark...· 0 citations
The global EOPC burden among WCBA and its links to core metabolic determinants are delineated, providing an evidence base to guide targeted interventions in this priority population and support progress toward international development goals.
Jiaxing Li, Jing Luo, Qi-Hui Hu et al.· PLoS ONE· 0 citations
Traditional environmental risk factors and established common genetic variants are not associated with the rising incidence of early-onset colorectal cancer, and drivers of early-onset disease might include novel environmental exposures or early-life factors beyond traditional risk assessment.
Anmol Nigam, Chidiebere Onongaya, Pravin Meshram et al.· Diseases of the Colon & Rect...· 0 citations
Current evidence on early-onset colorectal cancer epidemiology, biology, clinical presentation, screening, and treatment is summarized, and emerging directions including liquid biopsy, artificial intelligence, and microbiome-based strategies are highlighted.
Ahmed Sohaib, Ashwaq Salami, Wesal Alghwyeen et al.· Integrated Oncology Diagnost...· 0 citations
Background: The incidence of early-onset colorectal cancer (eoCRC), diagnosed at age <50 years, is increasing in the United States. Prior studies using national and state cancer databases have observed higher eoCRC mortality after diagnosis among non-Hispanic Black (NHB) patients. These studies, however, often did not account for insurance status, access to care, and comorbidity burden, which may contribute to the observed disparities. We examined the associations between race and ethnicity and neighborhood-level socioeconomic status [measured by the neighborhood deprivation index (NDI)] and survival among persons with eoCRC in a large integrated healthcare delivery system whose racially/ethnically diverse members have standardized access to care. Methods: We included Kaiser Permanente Southern California (KPSC) members diagnosed with eoCRC (age 15-49 years) between 2009-2020 and followed them through 12/31/2023. Patients with <12 months of prior KPSC membership, an unspecific CRC site, or other/unknown race/ethnicity were excluded. Bivariate and multivariable Cox models were used to estimate hazard ratios (HRs) for the associations between race/ethnicity and NDI and all-cause and CRC-specific mortality. Multivariable models were adjusted for age at diagnosis, sex, Charlson comorbidity score, obesity, stage at diagnosis, cancer site, and histologic subtype. Subgroup analyses were conducted by stage at diagnosis (localized vs. advanced). Results: Of 1,695 eoCRC cases included, we observed 465 deaths (among those with known cause, 417 (90.3%) were CRC-specific). The mean follow-up time was 6.8 years. In the adjusted models, NHB and non-Hispanic Asian/Pacific Islander (NH API) patients, but not Hispanic patients, had significantly higher all-cause mortality [HR=1.62, 95% CI: 1.14-2.29; HR=1.44 (1.08-1.93), respectively] compared with non-Hispanic White (NHW) patients. In the subgroup analyses, race and ethnicity were not associated with all-cause mortality among patients with localized disease. However, among patients diagnosed with advanced disease, NHB patients had a significantly higher risk of all-cause mortality compared with NHW patients (HR=1.54, 95% CI: 1.07-2.22, p=0.02). Similar findings were observed for CRC-specific mortality, overall and by cancer stage. NDI was not significantly associated with all-cause or CRC-specific mortality. Conclusions: In this insured population, NHB race and ethnicity were associated with increased risk of CRC-specific mortality among those diagnosed with advanced stage eoCRC. However, the number of NHB patients diagnosed at distant stages was small. Therefore, future research is needed to confirm these findings and better understand potential survival disparities.
T. Habeshian, Lan-Fang Xu, K. Cannavale et al.· Journal of Colon and Rectal...· 0 citations
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