Risk Factors for Early-Onset CRC Include High Cholesterol, Obesity

Hyperlipidemia, obesity, and alcohol consumption, as well as having a close relative with colorectal cancer, significantly increase the risk for early-onset colorectal cancer, according to a systematic review and meta-analysis published in Clinical Gastroenterology & Hepatology.

“Despite the widespread increase in the incidence of early-onset colorectal cancer, the reasons for this increase remain unclear,” wrote corresponding author Darren R. Brenner, PhD, of the University of Calgary in Canada, and coauthors, in the study background. “The objective of this study was to determine risk factors for the development of early-onset colorectal cancer.”

Some 20 studies were included in the review. Relative risks for early-onset colorectal cancer were 4.21 with a colorectal cancer history in a first-degree relative, 1.62 with hyperlipidemia, 1.54 with obesity, and 1.71 with high alcohol consumption compared with no alcohol consumption, according to the findings.

While smoking was associated with increased risk for early-onset colorectal cancer, it was not statistically significant. Researchers reported a 1.35 relative risk with smoking.

“Other potential risk factors included hypertension, metabolic syndrome, ulcerative colitis, chronic kidney disease, dietary factors, sedentary behaviour, and occupational exposure to organic dusts,” the authors wrote, “but these were only examined in one or two studies.”

Aside from those that focused on alcohol consumption, the studies in the review showed considerable heterogeneity.

“High-quality studies conducted on generalizable populations and that comprehensively examine risk factors for early-onset colorectal cancer are required to inform primary and secondary prevention strategies,” the authors advised.

—Jolynn Tumolo

Reference:
O'Sullivan DE, Sutherland RL, Town S, et al. Risk factors for early-onset colorectal cancer: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2022;20(6):1229-1240.e5.