Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta T2N 1N4, Canada; Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta T2N 1N4, Canada.
Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta T2N 1N4, Canada; Department of Oncology, University of Calgary, Calgary, Alberta T2N 1N4, Canada.
Cancer Epidemiol. 2024 Aug;91:102578. doi: 10.1016/j.canep.2024.102578. Epub 2024 May 14.
The incidence of early-onset (<50 years of age) colorectal cancer (eoCRC) has been steadily increasing in high-income countries including Canada. Despite this increase in incidence, the etiology of eoCRC remains unclear and prospective cohort studies of potential risk factors are limited.
We examined two prospective cohorts of healthy individuals (<50 years of age) who completed baseline questionnaires in the Ontario Health Study and Alberta's Tomorrow Project. We examined the associations between demographic characteristics, chronic health conditions, and lifestyle behaviours with the development of eoCRC using Cox proportional hazard models. Cohorts were analyzed separately and hazard ratios for each risk factor were pooled with random effects meta-analyses.
During an average follow-up of 6.63 years, 98 eoCRC cases occurred among study participants (n=127,852). A family history of CRC alone or with a history of other cancer types was associated with an increased risk of developing eoCRC (HR: 2.76, 95% CI: 1.43-5.32), but a family history of a non-CRC cancer only was not (HR: 1.18, 95% CI: 0.61-2.30). Heavy smokers (≥ 10 pack-years) at baseline had a higher risk of eoCRC compared to non-smokers (HR: 1.87, 95% CI: 1.00-3.52). Sex, socioeconomic factors, diabetes, alcohol consumption, among other factors were not significantly associated with the risk of eoCRC.
Our findings indicate that specific CRC risk factors are also associated with developing eoCRC. The data in the study offers valuable insights that could be integrated in future meta-analyses. Additional prospective cohort studies are required to understand the etiology of eoCRC.
包括加拿大在内的高收入国家，早发性（<50 岁）结直肠癌（eoCRC）的发病率一直在稳步上升。尽管发病率有所上升，但 eoCRC 的病因仍不清楚，潜在危险因素的前瞻性队列研究也很有限。
我们研究了参加安大略健康研究和艾伯塔省明日计划的两个健康人群（<50 岁）的前瞻性队列。我们使用 Cox 比例风险模型，研究了人口统计学特征、慢性健康状况和生活方式行为与 eoCRC 发展之间的关系。分别对队列进行分析，并使用随机效应荟萃分析汇总每个危险因素的风险比。
在平均 6.63 年的随访期间，研究参与者中发生了 98 例 eoCRC 病例（n=127852）。结直肠癌家族史或其他癌症家族史与 eoCRC 发病风险增加相关（HR：2.76，95%CI：1.43-5.32），但非结直肠癌家族史则不相关（HR：1.18，95%CI：0.61-2.30）。基线时重度吸烟者（≥10 包年）患 eoCRC 的风险高于非吸烟者（HR：1.87，95%CI：1.00-3.52）。性别、社会经济因素、糖尿病、饮酒等因素与 eoCRC 风险无显著相关性。
我们的研究结果表明，特定的 CRC 危险因素也与 eoCRC 的发生有关。本研究的数据提供了有价值的见解，可纳入未来的荟萃分析。需要开展更多的前瞻性队列研究来了解 eoCRC 的病因。
