Risk factors for early-onset colorectal cancer a population-based case–control study in Ontario, Canada

• Published in: Cancer causes & control Vol. 32; no. 10; pp. 1063 - 1083
• Main Authors: Chang, Vicky C., Cotterchio, Michelle, De, Prithwish, Tinmouth, Jill
• Format: Journal Article
• Language: English
• Published: Cham Springer Science + Business Media 01.10.2021; Springer International Publishing; Springer Nature B.V
• Subjects: Allergies; Asthma; Biomedical and Life Sciences; Biomedicine; Calcium; Cancer; Cancer Research; Case-Control Studies; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - etiology; Diet; Epidemiology; Female; Hematology; Humans; Oncology; Ontario - epidemiology; ORIGINAL PAPER; Population studies; Population-based studies; Public Health; Risk Factors; Sedentary behavior; Young Adult; Young adults; Ontario; Canada; Ontario Canada; Sedentary behavior; Early-onset colorectal cancer; Diet; Sugary drinks; Risk factors
• ISSN: 0957-5243; 1573-7225; 1573-7225
• DOI: 10.1007/s10552-021-01456-8

Purpose There has been an alarming increase in colorectal cancer (CRC) incidence among young adults aged < 50 years, and factors driving this upward trend are unknown. This study investigated associations between various medical, lifestyle, and dietary factors and risk of early-onset CRC (EO-CRC). Methods A population-based case–control study was conducted in Ontario, Canada during 2018–2019. EO-CRC cases aged 20–49 years ( n  = 175) were identified from the Ontario Cancer Registry; sex- and age group-matched controls ( n  = 253) were recruited through random digit dialing. Data on potential a priori risk factors were collected using a web-based self-reported questionnaire. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using multivariable logistic regression. Results Family history of CRC in a first- or second-degree relative (OR 2.37; 95% CI 1.47–3.84), longer sedentary time (≥ 10 vs. < 5 h/day, OR 1.93; 95% CI 1.02–3.65), greater consumption of sugary drinks (≥ 7 vs. < 1 drinks/week, OR 2.99; 95% CI 1.57–5.68), and a more Westernized dietary pattern (quartile 4 vs. 1, OR 1.92; 95% CI 1.01–3.66) were each associated with an increased risk of EO-CRC. Conversely, calcium supplement use (OR 0.53; 95% CI 0.31–0.92), history of allergy or asthma (OR 0.62; 95% CI 0.39–0.98), and greater parity in females (≥ 3 vs. nulliparity, OR 0.29; 95% CI 0.11–0.76) were each associated with a reduced risk. Conclusion Modifiable factors, particularly sedentary behavior and unhealthy diet including sugary drink consumption, may be associated with EO-CRC risk. Our findings, if replicated, may help inform prevention strategies targeted at younger persons.