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Review
. 2023 May 5:13:1132306.
doi: 10.3389/fonc.2023.1132306. eCollection 2023.

Risk factors for early-onset colorectal cancer: systematic review and meta-analysis

Hongmei Hua  1 , Qiuping Jiang  1 , Pan Sun  1 , Xing Xu  1
Affiliations
Review

Risk factors for early-onset colorectal cancer: systematic review and meta-analysis

Hongmei Hua et al. Front Oncol. .

Abstract

Background: The incidence of early-onset colorectal cancer (EOCRC), which means colorectal cancer diagnosed in patients under 50 years, has been increasing around the world. However, the etiology remains unclear. This study aims to identify risk factors for EOCRC.

Methods: This systematic review was conducted in PubMed, Embase, Scopus, and Cochrane Library databases from inception to November 25, 2022. We examined risk factors for EOCRC, including demographic factors, chronic conditions, and lifestyle behaviors or environmental factors. Random-effects/fixed-effects meta-analysis was adopted to combine effect estimates from published data. Study quality was evaluated with the Newcastle-Ottawa Scale (NOS). Statistical analysis was performed Revman5.3. Studies not suitable for the meta-analysis were analyzed by a systematic review.

Results: A total of 36 studies were identified for this review, and 30 studies were included in the meta-analysis. Significant risk factors for EOCRC included male (OR=1.20; 95% CI, 1.08-1.33), Caucasian (OR=1.44; 95% CI, 1.15-1.80), a family history of CRC (OR=5.90; 95% CI, 3.67-9.48), inflammatory bowel disease (OR=4.43; 95% CI, 4.05-4.84), obesity (OR=1.52; 95%CI, 1.20-1.91), overweight (OR=1.18; 95% CI, 1.12-1.25), triglycerides (OR=1.12; 95% CI, 1, 08-1.18), hypertension (OR=1.16; 95% CI, 1.12-1.21), metabolic syndrome (OR=1.29; 95% CI, 1.15-1.45), smoking (OR=1.44; 95% CI, 1.10-1.88), alcohol consumption (OR=1.41; 95% CI, 1.22-1.62), a sedentary lifestyle (OR=1.24; 95% CI, 1.05-1.46), red meat (OR=1.10; 95% CI, 1.04-1.16), processed meat (OR=1.53; 95% CI, 1.13-2.06), Western dietary patterns (OR=1.43; 95% CI, 1.18-1.73) and sugar-sweetened beverages (OR=1.55; 95% CI, 1.23-1.95). However, no statistical differences were found for hyperlipidemia and hyperglycemia. Vitamin D may be a protective factor (OR=0.72; 95% CI, 0.56-0.92). There was considerable heterogeneity among studies (I2>60%).

Conclusions: The study provides an overview of the etiology and risk factors of EOCRC. Current evidence can provide baseline data for risk prediction models specific to EOCRC and risk-tailored screening strategies.

Keywords: chronic conditions; colorectal cancer; demographics; early-onset; environmental factors; lifestyle factors; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Demographic risk factors for EOCRC. (A) Male; (B) Caucasian; (C) Family History.
Figure 3
Figure 3
Chronic conditions risk factors for EOCRC. (A) IBD (Inflammatory bowel disease); (B) Obesity; (C) Overweight; (D) Abdominal Obesity; (E) Hyperlipidemia; (F) Triglycerides; (G) Hypertension; (H) Diabetes; (I) MetS (Metabolic Syndrome).
Figure 4
Figure 4
Lifestyle risk factors for EOCRC. (A) Smoking; (B) Alcohol Consumed; (C) Sedentary; (D) Aspirin; (E) NSAID; (F) Red Meat; (G) Westernized Dietary Pattern; (H) Sugar-Sweetened Beverage; (I) Processed meat; (J) Vitamin D.
See this image and copyright information in PMC

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