In a new study, researchers found that several factors—including greater red meat intake, lower educational attainment, and heavier alcohol use—are linked to an increase in colorectal cancer in people under 50.
In the United States, incidence rates of early-onset colorectal cancer have nearly doubled between 1992 and 2013, with most of this increase due to early-onset cancers of the rectum.
Approximately 1 in 10 diagnoses of colorectal cancer in this country occurs in people under 50.
Researchers have observed the rise particularly among people born since the 1960s in studies from the United States, Canada, Australia, and Japan.
Such changes include decreases in consumption of fruits, non-potato vegetables, and calcium-rich dairy sources. This is coupled with an increase in processed foods (e.g., meats, pizza, macaroni and cheese, etc.) and soft drinks.
Average nutrient intakes of fiber, folate, and calcium among the U.S. population are also lower than recommended.
In the study, the team used data from 13 population-based studies, which included 3,767 colorectal cancer cases and 4,049 controls in people under 50 and 23,437 colorectal cancer cases and 35,311 controls in people 50 or above years.
They found early-onset colorectal cancer was linked to not regularly using aspirins, greater red meat intake, lower educational attainment, heavier alcohol use, and (interestingly enough) also alcohol abstinence.
Researchers also found that lower total fiber intake was linked more strongly to rectal than colon cancer.
Several other colorectal cancer risk factors trended toward an association with early-onset colorectal cancer, including the 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.
The team says this is the first large-scale study of non-genetic risk factors for early-onset colorectal cancer.
It provides the initial basis for targeted identification of those most at risk, which is imperative in mitigating the rising burden of this disease.
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The study is published in JNCI Cancer Spectrum. One author of the study is Richard Hayes.
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