U.S. researchers have identified several life factors identifiable at birth that impact on a person’s risk of being diagnosed with colorectal cancer (CRC) at a younger age.
Being a man or having Hispanic ethnicity were potential risk factors for colorectal cancer before the age of 50 years, according to the study in Cancer. Among women, being heavier at birth or having an older father also increased this risk.
Conversely, men and women with a foreign-born mother had a significantly decreased risk of having colorectal cancer at this younger age.
“Evaluating demographic, birth, and parental characteristics is important in understanding what’s causing the rising incidence of early-onset colorectal cancer,” said lead author Sunny Siddique, PhD, MPH, from the Yale School of Public Health.
“Our findings warrant future studies aimed to understand the mechanisms through which factors such as male sex, Hispanic ethnicity, birthweight, maternal birthplace, and paternal age may influence risk of early onset colorectal cancer.”
Colorectal cancer is the second most common cancer in the U.S and, while rates have declined among people 50 years of age in the past few decades, they have steadily increased in younger people.
Compared with colorectal cancer that occurs in later years, early-onset disease presents at an advanced stage, both because of its aggressiveness and delays in diagnosis. It is typically found in the rectum and distal colon, a location associated with Western diets.
Siddique and team compared the characteristics of 1221 people diagnosed with colorectal cancer before age 50 with 61,050 matched individuals without cancer, all living in California.
Multivariable analysis revealed that men had a 34% higher risk of early-onset colorectal cancer compared with women. Hispanic ethnicity was also linked with a 43% higher risk compared with being White.
Among women, every half-kilo increase in birthweight was associated with a 10% increase in early-onset disease, while having a father aged 35 years or older was linked with a 56% increase in risk.
Overall, having a mother born outside the U.S. was associated with a 15% lower risk of early-onset colorectal cancer.
Siddique and co-workers note that more than 60% of foreign-born mothers in their study were born in Mexico and they point to other research suggesting that first-generation, foreign-born Hispanic women tend to have healthier diet and less obesity during pregnancy than their U.S.-born counterparts.
The team speculates that the paternal-age finding may relate to increases in rate of de novo mutations among children born to older fathers.
Referring to the raised Hispanic risk, the researchers note that this ethnic group continues to experience barriers to accessing screening and care, including language and cultural competency, income, and a lack of health insurance.
“Per recent recommendations by the U.S. Preventive Services Task Force to initiate CRC screening among average-risk individuals aged 45 years or older, it is important to note that people younger than age 45 years are not eligible for routine screening,” they pointed out.
“Yet, our finding of Hispanic ethnicity being a risk factor for CRC is particularly relevant to this group of young individuals who are experiencing a high incidence of CRC.”
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