Metabolic syndrome, metabolic comorbid conditions and risk of early-onset colorectal cancer

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321661 ◽  
Author(s):  
Hanyu Chen ◽  
Xiaobin Zheng ◽  
Xiaoyu Zong ◽  
Zitong Li ◽  
Na Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metabolic Syndrome ◽  
Colon Cancer ◽  
Early Onset ◽  
Distal Colon ◽  
Comorbid Condition ◽  
Comorbid Conditions ◽  
Metabolic Dysregulation ◽  
Increased Risk ◽  
Early Onset Colorectal Cancer

ObjectiveFactors that lead to metabolic dysregulation are associated with increased risk of early-onset colorectal cancer (CRC diagnosed under age 50). However, the association between metabolic syndrome (MetS) and early-onset CRC remains unexamined.DesignWe conducted a nested case–control study among participants aged 18–64 in the IBM MarketScan Commercial Database (2006–2015). Incident CRC was identified using pathologist-coded International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, and controls were frequency matched. MetS was defined as presence of ≥3 conditions among obesity, hypertension, hyperlipidaemia and hyperglycaemia/type 2 diabetes, based on ICD-9-CM and use of medications. Multivariable logistic regressions were used to estimate ORs and 95% CIs.ResultsMetS was associated with increased risk of early-onset CRC (n=4673; multivariable adjusted OR 1.25; 95% CI 1.09 to 1.43), similar to CRC diagnosed at age 50–64 (n=14 928; OR 1.21; 95% CI 1.15 to 1.27). Compared with individuals without a metabolic comorbid condition, those with 1, 2 or ≥3 conditions had a 9% (1.09; 95% CI 1.00 to 1.17), 12% (1.12; 95% CI 1.01 to 1.24) and 31% (1.31; 95% CI 1.13 to 1.51) higher risk of early-onset CRC (ptrend <0.001). No associations were observed for one or two metabolic comorbid conditions and CRC diagnosed at age 50–64. These positive associations were driven by proximal (OR per condition 1.14; 95% CI 1.06 to 1.23) and distal colon cancer (OR 1.09; 95% CI 1.00 to 1.18), but not rectal cancer (OR 1.03; 95% CI 0.97 to 1.09).ConclusionsMetabolic dysregulation was associated with increased risk of early-onset CRC, driven by proximal and distal colon cancer, thus at least in part contribute to the rising incidence of early-onset CRC.

Metabolic syndrome, metabolic comorbid conditions, and risk of early-onset colorectal cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 1571-1571
Author(s):  
Hanyu Chen ◽  
Zitong Li ◽  
Xiaobin Zheng ◽  
Jinhee Hur ◽  
Xiaoyu Zong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metabolic Syndrome ◽  
Early Onset ◽  
Distal Colon ◽  
Comorbid Conditions ◽  
Diagnosis Codes ◽  
Increased Risk ◽  
Rising Incidence ◽  
Early Onset Colorectal Cancer

1571 Background: The etiology and contributors to the rising incidence of early-onset colorectal cancer (CRC diagnosed under age 50), driven largely by distal and rectal cancer, remain largely unknown. Metabolic syndrome is associated with higher risk of CRC diagnosed at older ages; however, its association with early-onset CRC remains unclear. Methods: We conducted a nested case-control study among participants aged 18-50 years with ≥2 years of enrollment and prescription drug coverage in the IBM MarketScan Commercial Databases (2006-2015). Incident CRC cases were identified using ICD-9-CM diagnosis codes. Controls without any cancer were identified using frequency matching on age, sex, geographical region, and duration of insurance enrollment. Metabolic syndrome was defined using either ICD-9-CM diagnosis codes or the presence of at least 3 of the following: obesity, hypertension, hyperlipidemia, and hyperglycemia/type 2 diabetes. In addition to ICD-9-CM codes, hypertension, hyperlipidemia, and hyperglycemia/type 2 diabetes were also defined based on regular use of medications. Multivariable logistic regressions were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: A total of 4,673 early-onset CRC and 40,832 controls were included. Metabolic syndrome was associated with increased risk of early-onset CRC (OR: 1.33, 95% CI 1.16-1.52), after adjusting for a range of potential confounders. The number of metabolic comorbid conditions was positively associated with risk of early-onset CRC in a dose-response fashion. Compared to individuals without any conditions, individuals with 1, 2, ≥3 metabolic conditions had a 13% (OR: 1.13, CI 1.04-1.22), 18% (OR: 1.18, CI 1.07-1.31), and 40% (OR: 1.40, CI 1.22-1.61) higher risk of early-onset CRC (Ptrend<0.001), respectively. These associations were driven by proximal (OR for ≥2 vs 0 metabolic comorbid conditions: 1.40, CI 1.15-1.69) and distal colon cancer, OR ≥2 vs 0: 1.25, CI 1.03-1.53), but not rectal cancer (OR≥2 vs 0: 1.07, CI 0.92-1.24). Conclusions: Metabolic syndrome and metabolic comorbid conditions were associated with increased risk of early-onset CRC, largely driven by proximal and distal colon cancer. Metabolic dysregulations may contribute to the rising incidence of early-onset CRC.

scholarly journals The gut microbiome and potential implications for early-onset colorectal cancer

2020 ◽  
Vol 9 (3) ◽  
pp. CRC25
Author(s):  
Reetu Mukherji ◽  
Benjamin A Weinberg
Keyword(s):  
Colorectal Cancer ◽  
Gut Microbiome ◽  
Early Onset ◽  
Older Patients ◽  
Fusobacterium Nucleatum ◽  
Distal Colon ◽  
Gastrointestinal Cancers ◽  
Human Gut ◽  
Colon And Rectal Cancer ◽  
Early Onset Colorectal Cancer

Recently, there has been an unexpected trend toward increased incidence of colorectal cancer in younger individuals, particularly distal colon and rectal cancer in those under age 50. There is evidence to suggest that the human gut microbiome may play a role in carcinogenesis. The microbiome is dynamic and varies with age, geography, ethnicity and diet. Certain bacteria such as Fusobacterium nucleatum have been implicated in the development of colorectal and other gastrointestinal cancers. Recent data suggest that bacteria can alter the inflammatory and immune environment, influencing carcinogenesis, lack of treatment response and prognosis. Studies to date focus on older patients. Because the microbiome varies with age, it could be a potential explanation for the rise in early-onset colorectal cancer.

Racial disparities in clinico-pathological features and survival rates of early-onset colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15089-e15089
Author(s):  
Ana Acuna Villaorduna ◽  
Meghan Kaumaya ◽  
Sanjay Goel
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Early Onset ◽  
Survival Rates ◽  
Screening Colonoscopy ◽  
Pathological Features ◽  
Risk Of Death ◽  
Common Location ◽  
Increased Risk ◽  
Early Onset Colorectal Cancer

e15089 Background: Early-onset colorectal cancer (EO-CRC) incidence is increasing disproportionately among minorities compared to Non-Hispanic Whites (NHW). EO-CRC have aggressive features such as higher grade and advanced stages. The appropriate age to start screening colonoscopy (SC) in NHW and minorities remains controversial; varying between 45 and 50 years old. We aim to compare EO-CRC clinico-pathological characteristics and survival rates by race groups. Methods: Patients with colorectal adenocarcinoma (CRC) with available race and stage as per AJCC 6th edition were identified using the SEER registry (1973-2010). EO-CRC was defined as CRC before age 50 years. Clinico-pathological features, overall survival (OS) by Kaplan Meier curves and mortality predictors by multivariate analysis were evaluated by race groups. Results: 180 605 patients with CRC were identified; 10.2% had EO-CRC. Mean age of diagnosis was 42.7 years and EO-CRC frequency was higher in minorities (Hispanics (H):16.7%, Non-Hispanic Black (NHB):12.7% and Asian (A): 12.8%) compared to NHW (8.7%). EO-CRC in NHB was predominantly seen in females. The rectum was the most common location for all races. Two-thirds of tumors were located between the sigmoid and anal regions in all races except NHB that had higher frequencies of right-sided tumors. Compared to other races, NHB had worse OS at all stages and tumor locations. NHB was associated with 72% increased risk of death by multivariate analysis. Conclusions: Our data suggest that EO-CRC frequency, pathological features and OS differ by race group; hence SC guidelines should be tailored accordingly. SC would be considered early; especially in minorities. Complete colonoscopy should be considered for NHB given higher rates of right-sided tumors and worse OS; while sigmoidoscopy may be adequate for others up to age 50, given higher rates of tumors located in the sigmoid to anal region. [Table: see text]

scholarly journals The sulfur microbial diet is associated with increased risk of early-onset colorectal cancer precursors

2021 ◽  
Author(s):  
Long H. Nguyen ◽  
Yin Cao ◽  
Jinhee Hur ◽  
Raaj S. Mehta ◽  
Daniel R. Sikavi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Early Onset ◽  
Increased Risk ◽  
Cancer Precursors ◽  
Early Onset Colorectal Cancer

scholarly journals GermlineTP53Mutations in Patients With Early-Onset Colorectal Cancer in the Colon Cancer Family Registry

JAMA Oncology ◽  
2015 ◽  
Vol 1 (2) ◽  
pp. 214 ◽  
Author(s):  
Matthew B. Yurgelun ◽  
Serena Masciari ◽  
Victoria A. Joshi ◽  
Rowena C. Mercado ◽  
Noralane M. Lindor ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Early Onset ◽  
Cancer Family ◽  
Colon Cancer Family Registry ◽  
Early Onset Colorectal Cancer

Detailed incidence and mortality trends of early-onset colorectal cancer in Canada.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15539-e15539
Author(s):  
Dylan E. O'Sullivan ◽  
Yibing Ruan ◽  
Robert Liam Sutherland ◽  
Winson Y. Cheung ◽  
Steven J. Heitman ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Late Stage ◽  
Early Onset ◽  
Age Group ◽  
Incidence And Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Early Onset Colorectal Cancer

e15539 Background: There has been a consistent increase in the incidence of early-onset colorectal cancer (eoCRC), under the age of 50, in Canada since the late 1990s. Questions remain surrounding how these trends vary by topography, histology, and stage, and related trends with CRC-specific mortality. Methods: CRC incidence data were obtained from the Canadian Cancer Registry and CRC-specific mortality data from the Canadian Vital Statistics – Death Database for the years 2000 to 2017. Age-specific average annual percent changes (AAPC) in the incidence (by topography and histology) and mortality rates of CRC were estimated using the National Cancer Institute’s Joinpoint Regression Program. To determine age-specific differences (5-year age groups) in CRC diagnosis at late stage (III and IV) for years 2011 to 2017 combined, a logistic regression model adjusting for sex with the 50-54 age group as the referent was conducted. Results: AAPCs and 95% confidence intervals in the rates of incidence (topography and histology) and mortality of eoCRC from 2000 to 2017 in Canada are presented in Table. Different trends in topography were observed across sexes with the largest increases in the distal colon (splenic flexure, descending, and sigmoid) and rectum among males and rectum only among females. Significant increases were observed for non-mucinous adenocarcinomas, while significant decreases were observed for mucinous adenocarcinomas among the 40-49 age group. Compared to the 50-54 age group, only the 45-49 group had a significantly higher odds of developing late-stage colon cancer, while men and adults 25-49 had a higher odds of developing late stage rectal cancer. Despite increases in the incidence of eoCRC there has only been a significant increase in mortality for men aged 20-39. Trends in mortality vary by site, with significant decreases observed for colon cancer-specific mortality among the 40-49 age group and increases in rectal cancer-specific mortality for adults aged 20-49. Conclusions: These results indicate that the largest increases in incidence and mortality for eoCRC have occurred in the rectum and trends have varied by sex. Further research on the etiology and treatment outcomes of eoCRC patients are warranted for this patient population.[Table: see text]

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