Risk factors for young-onset colorectal cancer

Rosato, Valentina; Bosetti, Cristina; Levi, Fabio; Polesel, Jerry; Zucchetto, Antonella; Negri, Eva; Vecchia, Carlo La

doi:10.1007/s10552-012-0119-3

Cited by 136 publications

(174 citation statements)

References 40 publications

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“…People aged below 40 years were more likely to develop colon cancer than people with 80+ years. This is contrary to what was variously reported by Rosato et al, [91] where rectal cancers occurred more in younger patients, while colon cancer occurred in patients on average a decade older. Lifestyle factors, especially alcohol consumption and cigarette smoking, are associated more with young onset of CRC [78, 87, 88].…”

Section: Discussioncontrasting

confidence: 99%

“…Our findings resemble those reported in low incidence populations, such as Thailand, India, and Chile [87]. Conversely, our findings differ from the work of Chalya et al [88] and other studies done in Africa where males were the primary CRC group [89–91]. These latter findings are similar to findings from those seen in high-risk populations and, of note, in previously low-risk populations currently experiencing a rising CRC incidence (i.e., Japan, Hong Kong, and Singapore) [80].…”

Section: Discussionsupporting

confidence: 60%

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Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

Katalambula

Ntwenya

Ngoma

et al. 2016

Journal of Cancer Epidemiology

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Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ 2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P = 0.0183) and time (P = 0.004) but not gender (P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P = 0.0405), age (P = 0.0015), and time (P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 60%

Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

Katalambula

Ntwenya

Ngoma

et al. 2016

Journal of Cancer Epidemiology

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“…2) consistent with the familial risk of tumors related to hereditary nonpolyposis colorectal cancer which is associated with a young age at onset. [36][37][38][39] We also found high familial aggregation of breast cancer at younger ages consistent with reports of higher prevalence of mutations in the BRCA1/BRCA2 genes in young patients and a high probability of the same gene mutations in their sisters. 40,41 Examining the changing risk with time since the index person's diagnosis, we found the pattern varied by cancer site: for colorectal and breast cancer, the risk profile for siblings was approximately constant for up to 20 years while for melanoma there was evidence of a small decline in risk in the first 5 years, and for prostate cancer a sharp decline.…”

Section: Epidemiologysupporting

confidence: 90%

“…The incidence rates differed by cancer site: for example, at age 60 years, the absolute risk (per 10,000 person years) of colorectal cancer in control siblings was 6.55 (95% CI: 5.86-7.31) compared to 16 (Table 2a). From age-stratified analysis, younger siblings had the highest IRR for colorectal cancer, breast cancer and prostate cancer, but the IRR was highest in 40-50 year old siblings for melanoma, although this was of similar magnitude to the IRR in the youngest siblings (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). The IRRs for each cancer decreased with age and were relatively stable in older ages.…”

Section: Absolute Risk Of Cancer By Agementioning

confidence: 88%

Patterns of changing cancer risks with time since diagnosis of a sibling

Lee

Czene

Rebora

et al. 2014

Intl Journal of Cancer

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Family history is a well-known risk factor for many cancers. However, it is important to know if/how the familial risk of cancer changes over time. For each of four major cancers (colorectal, breast, prostate and melanoma), we identified siblings of cancer patients (case siblings) and siblings of matched cancer-free controls sampled from Swedish population-based registers. Effects of age and time since diagnosis on sibling risks were examined using Poisson regression and presented graphically as smoothed hazard ratios (HRs). Screening effects were investigated by comparing hazards before/after the introduction of mammography for breast cancer and prostate-specific antigen (PSA) testing for prostate cancer. Case siblings had higher cancer incidence than control siblings for all cancers at all ages, with overall incidence rate ratios (IRRs) of 2.41 (95% confidence interval 2.14-2.71) for colorectal cancer, 2.37 (2.24-2.52) for breast cancer, 3.69 (3.46-3.93) for prostate cancer and 3.20 (2.72-3.76) for melanoma. Risks were highest in siblings who were young when the first cancer was diagnosed in the family, with siblings aged 30-40 having IRR 9.05 (3.03-27.00) for colorectal cancer and 4.30 (2.87-6.45) for breast cancer. Smoothed HRs remained fairly constant for up to 20 years except for prostate cancer, where the HR decreased steeply during the first few years. After introduction of PSA testing, men had higher incidence of prostate cancer shortly after diagnosis in a brother, but no such screening effect was found for breast cancer. Our findings can help inform the screening and counseling of family members of cancer patients.Family history is long recognized as an important risk factor for cancer and has also been found to be associated with cancer prognosis. One of the main, but simple, ways to begin to understand cancer etiology is by identifying the involvement of heritable genes through investigation of familial aggregation. There is a large body of published research providing estimates of increased risk for various cancer sites in different types of relatives. [1][2][3][4] However, in addition to the estimates of overall or lifetime increased risk in family members, it is important to know if/how this risk changes over time. To address this question, different time scales need to be considered when studying the relatives at risk: current age, age at the time of diagnosis of the first cancer in the family, elapsed time from the cancer diagnosis and calendar time.Age is the strongest risk factor for cancer onset and many studies show both the age of relatives and the age of the cancer patient at diagnosis to be associated with the family cancer risk. 5,6 Young age at onset of cancer has been shown to have high heritability and so is an important factor in familial risk. 7,8 However, few studies have investigated in detail how this risk changes with time since the first (index) cancer diagnosis in a family. 9 Such risk profiles would not only provide insight into underlying etiology but could also be used to ...

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“…However, to date, obesity, metabolic syndrome, and diabetes, have not been shown to be independently associated with young onset CRC 25–27 . Over the last few decades, the so-called “Western” diet – characterized by high intake of red meat, fat, and refined sugars and low intake of fiber and whole grains – has become more common in the US, Europe, and Asia, and particularly among children and adolescents 28 .…”

Section: Discussionmentioning

confidence: 98%

Rising Incidence of Colorectal Cancer Among Young Hispanics in Texas

Wang

Thrift²,

Zarrin-Khameh³

et al. 2017

Journal of Clinical Gastroenterology

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Goals To investigate trends in colorectal cancer (CRC) incidence and survival among Hispanics in Texas. Background The incidence of CRC is rising among young adults in the US. Given Texas’ large Hispanic population, investigating CRC trends in Texas may provide valuable insight into the future of CRC epidemiology in an ever-diversifying US population. Study Data from the Texas Cancer Registry (1995–2010) were used to calculate age-adjusted CRC rates based on the 2000 US standard population. Annual percentage change (APC) and five-year cancer-specific survival (CSS) rates were reported by age, race/ethnicity, stage, and anatomical location. Results Of 123,083 CRC cases, 11% occurred in individuals <50 years old, 26% of whom were Hispanic. Incidence was highest among African Americans (AAs; 76.3/100,000), followed by non-Hispanic whites (NHWs; 60.2/100,000) and Hispanics (50.8/100,000). Although overall CRC incidence declined between 1995 and 2010 (APC −1.8%, p<0.01), trends differed by age and race/ethnicity. Among individuals ≥50, the rate of decline was statistically significant among NHWs (APC −2.4%, p<0.01) and AAs (APC −1.3%, p<0.01) but not among Hispanics (APC −0.6%, p=0.13). In persons aged 20–39, CRC incidence rose significantly among Hispanics (APC 2.6%, p<.01) and NHWs (APC 2.4%, p<0.01), but not AAs (APC 0.3%, p =0.75). CSS rates among Hispanics and NHWs were comparable across most age groups and cancer stages whereas CSS rates among AAs were generally inferior to those observed among NHWs and Hispanics. Conclusion Although CRC incidence has declined in Texas, it is rising among young Hispanics and NHWs while declining more slowly among older Hispanics than among older NHWs and AAs.

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Risk factors for young-onset colorectal cancer

Cited by 136 publications

References 40 publications

Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

Patterns of changing cancer risks with time since diagnosis of a sibling

Rising Incidence of Colorectal Cancer Among Young Hispanics in Texas

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