Risk factors that predict Early-Onset of Colorectal Cancer in Male Veterans

The findings from a study published in the American Association for Cancer  Research (AACR)  strongly suggest that screening and identifying the independent risk factors may help combat the increasing incidence of colorectal cancer and predict early-onset colorectal cancer (EOCRC) in younger persons.

A comprehensive analysis of electronic databases and medical record review, Thomas F and his team conducted a comparison study on male veterans ages 35 to 49 years diagnosed with sporadic EOCRC (2008–2015) with 1:4 to clinic and colonoscopy controls without colorectal cancer (control group).

The significance of this study is:

· In the derivation cohort (75% of the total sample), univariate and multivariate logistic regression models were used to derive a complete and more parsimonious model. Both models were tested using a validation cohort.

· Among 600 cases of sporadic EOCRC [mean (SD) age 45.2 (3.5) years; 66% White], 1,200 primary care clinic controls [43.4 (4.2) years; 68% White], and 1,200 colonoscopy controls [44.7 (3.8) years; 63% White].

· The study yielded a roster of independent risk factors associated with EOCRC, encompassing age, cohabitation and employment status, body mass index (BMI), comorbidity, familial history of colorectal or other visceral cancers, alcohol use, exercise habits, hyperlipidemia, usage of statins, nonsteroidal anti-inflammatory drugs (NSAIDs), and multivitamin consumption.

· Logistic regression models were employed to derive both a full model and a more concise model, which were subsequently validated

· Validation c-statistics were 0.75–0.76 for the complete model and 0.74–0.75 for the parsimonious model, respectively.

The rising of EOCRC is becoming a threat and needs a proactive approach to it by risk factor identification and early screening. Additionally, the study aims to unlock the various independent risk factors that could guide decisions regarding early screening. Implementing the risk factors also provided a powerful screening tool to identify veterans for whom colorectal cancer screening should be considered before the age of 45 or 50 years old.

Furthermore, the authors noted that the analysis demonstrated a powerful predictive ability, suggesting that these risk factors can aid in identifying individuals who should be considered for earlier colorectal cancer screening, particularly among those under 45 or 50 years old.

References: Imperiale, T.F., Myers, L.J., Barker, B.C., Larson, J., Stump, T.E. and Daggy, J.K., 2023. Risk Factors for Early-onset Sporadic Colorectal Cancer in Male Veterans. Cancer Prevention Research, pp.OF1-OF10.

https://doi.org/10.1158/1940-6207