Epidemiology and genetics of early onset colorectal cancer—African overview with a focus on Ethiopia

Anugwom, Chimaobi M.; Braimoh, Grace; Sultan, Amir; Johnson, Willie Mohammed; Debes, José D.; Mohammed, Abdulsemed

doi:10.1053/j.seminoncol.2023.03.007

Cited by 8 publications

(6 citation statements)

References 50 publications

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“…It is important to note that Asia accounts for half of the colon cancer burden worldwide, especially China, which has the highest deaths and disability rates from colon cancer, attributable to dietary risks, followed by the United States, India, and Japan [ 21 , 22 ]. A similar contrasting result was documented in this sub-Saharan Africa study, where crude incidence was reported to be low (4.40 per 100,000) [ 23 ]; however, it is associated with higher mortality and morbidity [ 24 ]. This racial disparity is reflected in this study using National Cancer Institute (NCI) epidemiology data [ 25 ].…”

Section: Reviewsupporting

confidence: 63%

Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis

Lingas

2023

Cureus

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Colon cancer remains a leading cause of cancer-related deaths, and there has been a rise in the incidence of early-onset colon cancer or colon cancer diagnosed before the age of 50 years old. Early-onset colon cancer has several differences in clinical presentation, as well as histopathology, genetic alteration, and molecular profiling. Early-onset colon cancer can be differentiated into familial type that includes hereditary familial syndrome and sporadic type. Demographic variance also exists in both developing and developed countries. Due to the rising incidence of colon cancer diagnosed in younger age, it is imperative to examine the available evidence regarding the mortality rate of early-onset colon cancer. Colon cancer is affected by numerous modifiable and non-modifiable risk factors. Increasing obesity and lifestyle disorders in the younger population, such as smoking, may influence this increasing trend. There are existing guidelines for colon cancer screening in both average-risk and high-risk individuals. This narrative review aims to highlight the pathogenesis of early-onset CRC; its clinical presentation, treatment, prognosis; and how it differs from late-onset CRC.

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Section: Reviewsupporting

confidence: 63%

Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis

Lingas

2023

Cureus

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“…By 2030, it is estimated that 1 in 10 new cases of colon cancer and 1 in 4 cases of rectal cancer will occur in young people. EOCRC is on the rise in many countries [ 7 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…This implies that the driving factors for the increase in EOCRC are environmental, although there is presumably an interplay between genes and the environment. The rise in the incidence of EOCRC has now been documented in many countries [ 3 , 6 , 7 ]. While an increasing prevalence of obesity, high processed foods diets, diabetes, smoking, alcohol consumption, and sedentary lifestyles have been implicated in EOCRC, these lifestyle and comorbidity factors have been present since the 1950s, and the marked increase in EOCRC was noted beginning in the 1990s [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Pharmaceutical Agents as Potential Drivers in the Development of Early-Onset Colorectal Cancer: Case-Control Study

Ben-Aharon,

Rotem,

Melzer-Cohen

et al. 2023

JMIR Public Health Surveill

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Background The incidence of early-onset colorectal cancer (EOCRC) rose abruptly in the mid 1990s, is continuing to increase, and has now been noted in many countries. By 2030, 25% of American patients diagnosed with rectal cancer will be 49 years or younger. The large majority of EOCRC cases are not found in patients with germline cancer susceptibility mutations (eg, Lynch syndrome) or inflammatory bowel disease. Thus, environmental or lifestyle factors are suspected drivers. Obesity, sedentary lifestyle, diabetes mellitus, smoking, alcohol, or antibiotics affecting the gut microbiome have been proposed. However, these factors, which have been present since the 1950s, have not yet been conclusively linked to the abrupt increase in EOCRC. The sharp increase suggests the introduction of a new risk factor for young people. We hypothesized that the driver may be an off-target effect of a pharmaceutical agent (ie, one requiring regulatory approval before its use in the general population or an off-label use of a previously approved agent) in a genetically susceptible subgroup of young adults. If a pharmaceutical agent is an EOCRC driving factor, regulatory risk mitigation strategies could be used. Objective We aimed to evaluate the possibility that pharmaceutical agents serve as risk factors for EOCRC. Methods We conducted a case-control study. Data including demographics, comorbidities, and complete medication dispensing history were obtained from the electronic medical records database of Maccabi Healthcare Services, a state-mandated health provider covering 26% of the Israeli population. The participants included 941 patients with EOCRC (≤50 years of age) diagnosed during 2001-2019 who were density matched at a ratio of 1:10 with 9410 control patients. Patients with inflammatory bowel disease and those with a known inherited cancer susceptibility syndrome were excluded. An advanced machine learning algorithm based on gradient boosted decision trees coupled with Bayesian model optimization and repeated data sampling was used to sort through the very high-dimensional drug dispensing data to identify specific medication groups that were consistently linked with EOCRC while allowing for synergistic or antagonistic interactions between medications. Odds ratios for the identified medication classes were obtained from a conditional logistic regression model. Results Out of more than 800 medication classes, we identified several classes that were consistently associated with EOCRC risk across independently trained models. Interactions between medication groups did not seem to substantially affect the risk. In our analysis, drug groups that were consistently positively associated with EOCRC included beta blockers and valerian (Valeriana officinalis). Antibiotics were not consistently associated with EOCRC risk. Conclusions Our analysis suggests that the development of EOCRC may be correlated with prior use of specific medications. Additional analyses should be used to validate the results. The mechanism of action inducing EOCRC by candidate pharmaceutical agents will then need to be determined.

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“…Family history of the disease, especially among first-degree relatives, can also elevate the risk. Inherited genetic mutations, such as those seen in Lynch syndrome or familial adenomatous polyposis, can substantially increase the susceptibility to colorectal cancer. , Additionally, lifestyle choices, such as a diet high in red and processed meats, low fiber intake, tobacco use, excessive alcohol consumption, and physical inactivity, are modifiable factors that can contribute to the development of colorectal cancer. The symptoms of colorectal cancer can be subtle in the early stages, making it imperative to recognize the potential warning signs.…”

Section: Overview Of Colorectal Cancer and Precision Medicinementioning

confidence: 99%

Advances in Precision Medicine Approaches for Colorectal Cancer: From Molecular Profiling to Targeted Therapies

Kiran,

Yashaswini,

Maheshwari

et al. 2024

ACS Pharmacol. Transl. Sci.

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Precision medicine is transforming colorectal cancer treatment through the integration of advanced technologies and biomarkers, enhancing personalized and effective disease management. Identification of key driver mutations and molecular profiling have deepened our comprehension of the genetic alterations in colorectal cancer, facilitating targeted therapy and immunotherapy selection. Biomarkers such as microsatellite instability (MSI) and DNA mismatch repair deficiency (dMMR) guide treatment decisions, opening avenues for immunotherapy. Emerging technologies such as liquid biopsies, artificial intelligence, and machine learning promise to revolutionize early detection, monitoring, and treatment selection in precision medicine. Despite these advancements, ethical and regulatory challenges, including equitable access and data privacy, emphasize the importance of responsible implementation. The dynamic nature of colorectal cancer, with its tumor heterogeneity and clonal evolution, underscores the necessity for adaptive and personalized treatment strategies. The future of precision medicine in colorectal cancer lies in its potential to enhance patient care, clinical outcomes, and our understanding of this intricate disease, marked by ongoing evolution in the field. The current reviews focus on providing in-depth knowledge on the various and diverse approaches utilized for precision medicine against colorectal cancer, at both molecular and biochemical levels.

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Epidemiology and genetics of early onset colorectal cancer—African overview with a focus on Ethiopia

Cited by 8 publications

References 50 publications

Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis

Early-Onset Colon Cancer: A Narrative Review of Its Pathogenesis, Clinical Presentation, Treatment, and Prognosis

Pharmaceutical Agents as Potential Drivers in the Development of Early-Onset Colorectal Cancer: Case-Control Study

Advances in Precision Medicine Approaches for Colorectal Cancer: From Molecular Profiling to Targeted Therapies

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