可改变和不可改变的早发性结直肠癌风险因素：国家健康访谈调查分析。

Modifiable and non-modifiable risk factors of early-onset colorectal cancer: National Health Interview Survey analysis.

机构信息

College of Pharmacy, The University of Texas at Austin, Austin, TX, United States.

出版信息

Cancer Epidemiol. 2024 Dec;93:102682. doi: 10.1016/j.canep.2024.102682. Epub 2024 Oct 8.

DOI:10.1016/j.canep.2024.102682

PMID:39383618

Abstract

BACKGROUND AND AIMS

Although the incidence of colorectal cancer (CRC) diagnosed in individuals younger than 50 years, early-onset CRC (EO-CRC), is rapidly increasing, the risk factors for EO-CRC are still being identified. This study aimed to confirm the modifiable and non-modifiable characteristics identified as risk factors for EO-CRC.

METHODS

This cross-sectional study used 2004-2018 National Health Interview Survey (NHIS) data, which provides comprehensive health information gathered from national annual household interview surveys. Demographic, clinical, and behavioral characteristics of EO-CRC patients were compared with those without. In addition, their non-age-related characteristics (gender, race/ethnicity, region, body mass index [BMI], alcohol consumption, and smoking status) were compared with individuals with average-onset CRC (AO-CRC). For both comparisons, multivariable logistic regression analyses were performed.

RESULTS

We identified 156 patients with EO-CRC, 204,846 with non-CRC, and 1972 with AO-CRC. Comparison between the EO-CRC and the non-CRC groups showed that higher odds of having EO-CRC was associated with older age (Odds Ratio [OR]=1.11, 95 % CI=1.08-1.14, p<0.001), living in the Midwest (vs. South) (OR=1.64, 95 % CI=1.06-2.55, p=0.03), and history of alcohol consumption (vs. lifetime abstainer) (OR=2.09, 95 % CI=1.01-4.36, p=0.049). Lower odds of having EO-CRC were associated with being Hispanic (OR=0.43, 95 % CI=0.22-0.84, p=0.01) or Asian (OR=0.38, 95 % CI=0.16-0.92, p=0.03) (vs. non-Hispanic White) and having moderate or vigorous physical activities (vs. no activity) (OR=0.58, 95 % CI=0.34-0.999, p=0.0496 and OR=0.34; 95 % CI=0.21-0.55, p<0.0001, respectively). Compared with patients with AO-CRC, patients with EO-CRC were more likely to be Hispanic (vs. non-Hispanic White) (OR=2.21, 95 % CI=1.13-4.33, p=0.02).

CONCLUSION

This study verified several modifiable (i.e., alcohol consumption and physical activity) and non-modifiable (i.e., race/ethnicity) risk factors while also discovering a new factor (i.e., geographical region) associated with EO-CRC.

摘要

背景与目的

尽管 50 岁以下人群（早发性结直肠癌，EO-CRC）的结直肠癌发病率迅速上升，但 EO-CRC 的风险因素仍在不断确定。本研究旨在确认作为 EO-CRC 风险因素的可改变和不可改变的特征。

方法

本横断面研究使用了 2004 年至 2018 年全国健康访谈调查（NHIS）的数据，该数据提供了从全国年度家庭访谈调查中收集的综合健康信息。将 EO-CRC 患者的人口统计学、临床和行为特征与无 CRC 患者进行比较。此外，将他们与平均发病 CRC（AO-CRC）患者的非年龄相关特征（性别、种族/民族、地区、体重指数 [BMI]、饮酒和吸烟状况）进行了比较。对于这两种比较，均进行了多变量逻辑回归分析。

结果

我们确定了 156 例 EO-CRC 患者、204846 例非 CRC 患者和 1972 例 AO-CRC 患者。与非 CRC 组相比，EO-CRC 组的年龄更大（优势比 [OR]=1.11，95%可信区间 [CI]=1.08-1.14，p<0.001）、居住在中西部（与南部相比）（OR=1.64，95%CI=1.06-2.55，p=0.03）和有饮酒史（与终生戒酒者相比）（OR=2.09，95%CI=1.01-4.36，p=0.049）的可能性更高。与 EO-CRC 相关的较低可能性包括具有西班牙裔（OR=0.43，95%CI=0.22-0.84，p=0.01）或亚裔（OR=0.38，95%CI=0.16-0.92，p=0.03）（与非西班牙裔白人相比）和进行中等或剧烈的身体活动（与无活动相比）（OR=0.58，95%CI=0.34-0.999，p=0.0496 和 OR=0.34；95%CI=0.21-0.55，p<0.0001）。与 AO-CRC 患者相比，EO-CRC 患者更有可能是西班牙裔（与非西班牙裔白人相比）（OR=2.21，95%CI=1.13-4.33，p=0.02）。