Identifying 7 Risk Factors for Early-Onset Colorectal Cancer in Men

While colorectal cancer incidence and death rates are declining for individuals aged 50 and older, the numbers are increasing for those under 50. A new study identified 7 risk factors for early onset of colorectal cancer in male patients. The results were published in Cancer Prevention Research.

The study comprised 600 individuals (all male veterans between the ages of 35 and 49 years, 30% Black) with nonhereditary colorectal cancer plus 2400 control patients from US Department of Veterans Affairs (VA) medical centers across the United States. The investigators used electronic health record data and national VA datasets to determine sociodemographic and lifestyle factors, family and personal medical history, physical measures, vital signs, medications, and laboratory values for 6 to 18 months. The researchers initially identified 15 variables linked with early-onset colorectal cancer. They then condensed their prediction model down to 7 factors that would provide a similar level of precision and allow for easier estimation of relative risk in a clinical setting.

The 7 factors linked with an increased risk of colorectal cancer include:

• Older age (within the 35- to 49-year-old age range)
• No regular use of nonsteroidal anti-inflammatory drugs (such as aspirin or ibuprofen)
• No regular use of statins
• Current alcohol use
• A family history of colorectal cancer
• A higher disease burden
• Service-connection/copay variable (a marker for socio-economic status)

According to lead researcher Thomas Imperiale, MD, of the VA, Regenstrief Institute, and Indiana University School of Medicine, “This study is important because it puts whether, and possibly how, to screen people who are younger than age 45—below the age for recommended colorectal cancer screening—and [who] have some of the risk factors we identify on the table for consideration for screening.”

“We know that colon cancer at younger ages is on the rise, although the absolute risk is still much lower than even in the 45- to 54-year-old age group. Nonetheless, that doesn’t mean that we shouldn’t be trying to identify younger people at higher risk to screen them with some modality,” Dr. Imperiale added.