Diet as a Risk Factor for Early-Onset Colorectal Adenoma and Carcinoma: A Systematic Review

Carroll, Kaitlin L; Frugé, Andrew D.; Heslin, Martin J.; Lipke, Elizabeth A.; Greene, Michael W.

doi:10.3389/fnut.2022.896330

Cited by 23 publications

(14 citation statements)

References 51 publications

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“…In addition, there were few studies included in the above meta-analysis, and the results may be biased. Carroll et al (16) and Li et al (17) only evaluated a single factor in their systematic reviews, and could not determine all the risk factors related to EOCRC. With the in-depth study of EOCRC in recent years, it is very important to identify the risk factors that may increase EOCRC through a comprehensive literature search.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for early-onset colorectal cancer: systematic review and meta-analysis

et al. 2023

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BackgroundThe incidence of early-onset colorectal cancer (EOCRC), which means colorectal cancer diagnosed in patients under 50 years, has been increasing around the world. However, the etiology remains unclear. This study aims to identify risk factors for EOCRC.MethodsThis systematic review was conducted in PubMed, Embase, Scopus, and Cochrane Library databases from inception to November 25, 2022. We examined risk factors for EOCRC, including demographic factors, chronic conditions, and lifestyle behaviors or environmental factors. Random-effects/fixed-effects meta-analysis was adopted to combine effect estimates from published data. Study quality was evaluated with the Newcastle-Ottawa Scale (NOS). Statistical analysis was performed Revman5.3. Studies not suitable for the meta-analysis were analyzed by a systematic review.ResultsA total of 36 studies were identified for this review, and 30 studies were included in the meta-analysis. Significant risk factors for EOCRC included male (OR=1.20; 95% CI, 1.08-1.33), Caucasian (OR=1.44; 95% CI, 1.15-1.80), a family history of CRC (OR=5.90; 95% CI, 3.67-9.48), inflammatory bowel disease (OR=4.43; 95% CI, 4.05-4.84), obesity (OR=1.52; 95%CI, 1.20-1.91), overweight (OR=1.18; 95% CI, 1.12-1.25), triglycerides (OR=1.12; 95% CI, 1, 08-1.18), hypertension (OR=1.16; 95% CI, 1.12-1.21), metabolic syndrome (OR=1.29; 95% CI, 1.15-1.45), smoking (OR=1.44; 95% CI, 1.10-1.88), alcohol consumption (OR=1.41; 95% CI, 1.22-1.62), a sedentary lifestyle (OR=1.24; 95% CI, 1.05-1.46), red meat (OR=1.10; 95% CI, 1.04-1.16), processed meat (OR=1.53; 95% CI, 1.13-2.06), Western dietary patterns (OR=1.43; 95% CI, 1.18-1.73) and sugar-sweetened beverages (OR=1.55; 95% CI, 1.23-1.95). However, no statistical differences were found for hyperlipidemia and hyperglycemia. Vitamin D may be a protective factor (OR=0.72; 95% CI, 0.56-0.92). There was considerable heterogeneity among studies (I2>60%).ConclusionsThe study provides an overview of the etiology and risk factors of EOCRC. Current evidence can provide baseline data for risk prediction models specific to EOCRC and risk-tailored screening strategies.

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Section: Introductionmentioning

confidence: 99%

Risk factors for early-onset colorectal cancer: systematic review and meta-analysis

et al. 2023

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“…The factors driving the increase in EOCRC incidence are unknown but are likely to be multifactorial. LOCRC appears to be driven by the interaction of an individual's microbiome and diet, with conventional risk factors, such as obesity, alcohol, processed meat, sugary drinks, and a 'Western diet' (high fat, high meat, and low fibre), and such mechanisms are likely with EOCRC [41][42][43][44][45][46][47], However the mechanism must be different from LOCRC to be driving different changes in incidence. While several bacterial species have already been implicated in adenoma or LOCRC development [48][49][50], data specific to EOCRC suggest that the microbiome in patients with EOCRC is different compared that found in patients with LOCRC and healthy controls [51].…”

Section: Discussionmentioning

confidence: 99%

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

Waddell,

Pearson,

McCombie

et al. 2024

BMC Cancer

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Background The incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50, has been rising in many countries in the past few decades. This study aims to evaluate this trend in Aotearoa New Zealand and assess its impact on Māori. Methods Crude incidence and age-standardized incidence of colorectal cancer (CRC) was analyzed from all new cases from the Aotearoa New Zealand national cancer registry for the period 2000–2020. Trends were estimated by sex, ethnicity, age group and location of cancer and projections made to 2040. Results Between 2000 and 2020, there were a total of 56,761 cases of CRC diagnosed in Aotearoa New Zealand, 3,702 of these being EOCRC, with age-standardized incidence decreasing significantly (P = 8.2 × 10− 80) from 61.0 to 47.3 cases per 100,000. EOCRC incidence increased on average by 26% per decade (incidence rate ratio (IRR) 1.26, p = < 0.0001) at all sites (proximal colon, distal colon and rectum), while the incidence in those aged 50–79 years decreased on average by 18% per decade (IRR 0.82, p = < 0.0005), again across all sites. There was no significant average change in CRC incidence in those over 80 years. In Māori, there was no significant change in age-standardized incidence. There was however a significant increase in crude incidence rates (IRR 1.28, p = < 0.0005) driven by significant increases in EOCRC (IRR1.36, p = < 0.0005). By 2040, we predict the incidence of EOCRC will have risen from 8.00 to 14.9 per 100,000 (6.33 to 10.00 per 100,000 in Māori). However, due to the aging population an estimated 43.0% of all CRC cases will be diagnosed in those over 80 years of age (45.9% over 70 years of age in Māori). Conclusion The age-standardized incidence of CRC from 2000 to 2020 decreased in Aotearoa New Zealand, but not for Māori. The incidence of EOCRC over the same period continues to rise, and at a faster rate in Māori. However, with the ageing of the population in Aotearoa New Zealand, and for Māori, CRC in the elderly will continue to dominate case numbers.

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“…Current studies suggest that modifiable lifestyle factors, such as diet composition, play important roles in the occurrence and progression of CRC ( 66 ). A multicenter prospective cohort study on dietary patterns and risk of early-onset high-risk adenomas (EO-HRA) as precursors to EO-CRC reveals that Western diet consumption is an EO-HRA risk factor (OR, 1.67), while a “prudent diet” is protective (OR, 0.69) ( 67 ).…”

Section: Discussionmentioning

confidence: 99%

High-fat diet plus HNF1A variant promotes polyps by activating β-catenin in early-onset colorectal cancer

Song¹,

Sontz²,

Vance³

et al. 2023

JCI Insight

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The incidence of early-onset colorectal cancer (EO-CRC) is rising and is poorly understood. Lifestyle factors and altered genetic background possibly contribute. Here, we performed targeted exon sequencing of archived leukocyte DNA from 158 EO-CRC participants, which identified a missense mutation at p.A98V within the proximal DNA binding domain of Hepatic Nuclear Factor 1 α (HNF1A A98V , rs1800574). The HNF1A A98V exhibited reduced DNA binding. To test function, the HNF1A variant was introduced into the mouse genome by CRISPR/Cas9, and the mice were placed on either a high-fat diet (HFD) or high-sugar diet (HSD). Only 1% of the HNF1A mutant mice developed polyps on normal chow; however, 19% and 3% developed polyps on the HFD and HSD, respectively. RNA-Seq revealed an increase in metabolic, immune, lipid biogenesis genes, and Wnt/β-catenin signaling components in the HNF1A mutant relative to the WT mice. Mouse polyps and colon cancers from participants carrying the HNF1A A98V variant exhibited reduced CDX2 and elevated β-catenin proteins. We further demonstrated decreased occupancy of HNF1A A98V at the Cdx2 locus and reduced Cdx2 promoter activity compared with WT HNF1A. Collectively, our study shows that the HNF1A A98V variant plus a HFD promotes the formation of colonic polyps by activating β-catenin via decreasing Cdx2 expression.

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Diet as a Risk Factor for Early-Onset Colorectal Adenoma and Carcinoma: A Systematic Review

Cited by 23 publications

References 51 publications

Risk factors for early-onset colorectal cancer: systematic review and meta-analysis

Risk factors for early-onset colorectal cancer: systematic review and meta-analysis

The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000–2020

High-fat diet plus HNF1A variant promotes polyps by activating β-catenin in early-onset colorectal cancer

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