Abstract
Background As the third most common type of cancer in the United States, colorectal cancer (CRC) was previously thought to be rare in young populations. Despite a decrease in the overall incidence of CRC, the rate of new cases under 50 years old has been continuously increasing. Aim The purpose of our study was to analyze risk factors of young-onset CRC. Methods Commercially available software platform, Explorys, was used to extract data from a collective healthcare database electronically. Results In this database, 13,800 young adults (age 20–50) were diagnosed with primary colorectal malignancy. Compared to subjects with a previous family history of CRC who had an odds ratio of 17.78, those diagnosed with primary malignant neoplasm of breast and inflammatory bowel disease (ulcerative colitis and Crohn's) had odds ratios of 16.94, 4.4, and 3.7 for young-onset CRC, respectively. Patients with a history of alcohol abuse, smoking, obesity, diabetes mellitus, and hyperlipidemia had higher chances of developing young-onset CRC. In addition, the odds of CRC were lower in Hispanic ethnicity in comparison to Caucasians (OR: 0.54), with no statically significant differences between Caucasian, African American, and Asian populations. Conclusion Currently, this is an expansive study investigating the risk factors for early-onset CRC. The analysis showed factors such as family and individual history of IBD to have high association with early onset. Notably, an individual history of breast malignancy was strongly associated with early-onset CRC.
Highlights
Colorectal cancer (CRC) is ranked as the third most common malignancy and cause of mortality in men and women
Incidence and mortality rates have been showing a significant upward trend in those younger than 50 years old [2, 3]. Following this marked increase in colorectal cancer (CRC), in young individuals, American Cancer Society (ACS) proposed to decrease the age threshold of CRC screening to 45 years for the average-risk population [4], and American College of Gastroenterology suggested that starting CRC screening at the age of 45 will reduce the mortality from CRC [5]
E odds ratio of having young-onset colorectal cancer increased with age, reaching 34.89 in the age group of 45–49 years when compared to 20–25 age group as the reference group (Figure 2)
Summary
As the third most common type of cancer in the United States, colorectal cancer (CRC) was previously thought to be rare in young populations. Aim. e purpose of our study was to analyze risk factors of young-onset CRC. In this database, 13,800 young adults (age 20–50) were diagnosed with primary colorectal malignancy. Compared to subjects with a previous family history of CRC who had an odds ratio of 17.78, those diagnosed with primary malignant neoplasm of breast and inflammatory bowel disease (ulcerative colitis and Crohn’s) had odds ratios of 16.94, 4.4, and 3.7 for young-onset CRC, respectively. This is an expansive study investigating the risk factors for early-onset CRC. E analysis showed factors such as family and individual history of IBD to have high association with early onset. An individual history of breast malignancy was strongly associated with early-onset CRC
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