A recent study identified seven risk factors for early-onset colorectal cancer in males under 50, potentially improving screening practices. Colorectal cancer rates have been rising among younger individuals, leading to a decrease in the recommended screening age from 50 to 45. The risk evaluation model utilized electronic health record data and identified factors such as age, medication use, alcohol consumption, family history, and disease burden. The findings may guide discussions and noninvasive screening options for high-risk individuals.
A recent study published in Cancer Prevention Research has identified seven risk factors associated with early onset colorectal cancer in males under the age of 50. These findings have the potential to improve screening practices and adherence to national recommendations for this disease.
Colorectal cancer is the third most commonly diagnosed cancer in both men and women in the United States, with a decline in diagnoses observed among older populations since the mid-1980s. However, the incidence rates of colorectal cancer have been steadily increasing by one to two percent per year in individuals younger than 50.
In response to this trend, the US Preventive Services Task Force (USPSTF) recently lowered the recommended age for colorectal cancer screening from 50 to 45 for adults at average risk. Nonetheless, there is a need for further measures to enhance outcomes for younger populations.
To address this, researchers developed a risk evaluation model to identify specific risk factors for early-onset colorectal cancer in younger males. The study aimed to determine if the same set of risk factors applicable to older populations would also apply to those under 50.
The lead author of the study, Dr. Thomas Imperiale, emphasized the importance of this research in considering screening options for individuals under the recommended age. He suggested that even though the absolute risk of colorectal cancer is lower in younger patients compared to those aged 45 to 54, identifying high-risk individuals in the younger age group is crucial for improving outcomes.
Clinicians can engage in discussions with patients and recommend noninvasive screening tests such as fecal occult blood testing or multi-target stool DNA testing, even for those below the recommended screening age but with identifiable risk factors.
To construct the risk model, the researchers collected electronic health record (EHR) data from 600 male patients between the ages of 35 and 49 who had non-hereditary colon or rectal cancer, along with 2,400 control patients, from US Veterans Affairs medical centers. The model incorporated various factors including lab values, vital signs, medications, medical history, sociodemographic information, and lifestyle factors.
The identified risk factors for early-onset colorectal cancer in males were as follows: older age (within the 35- to 49-year-old range), lack of regular use of non-steroidal anti-inflammatory drugs, lack of regular use of statins, current alcohol use, having a first or second degree relative with colorectal cancer, higher disease burden, and service-connection/copay variable.
The researchers believe that most of these risk factors, except for the service-connection/copay variable, are not unique to the veteran population and can be generalized to the wider population.
Future research will focus on analyzing data to identify risk factors for early-onset colorectal cancer in female veterans.
Recent studies have aimed to address colorectal cancer by mitigating risks and improving screening, including research on the risks associated with ultra-processed food consumption and the exploration of traditional and experimental screening methods.
Additionally, Mayo Clinic researchers have developed an artificial intelligence (AI) model leveraging deep learning and tumor images to predict recurrence and survival in colorectal cancer patients accurately. This model assists in determining the need for chemotherapy or other intensive treatments based on an individual’s probability of cancer recurrence.
