Risk factors for early-onset colorectal cancer:A large-scale Chinese cohort study

Background:The incidence of early-onset colorectal cancer(EOCRC)has increased globally since the early 1990s.Comprehensively examining the risk factors would be helpful for risk stratification and the development of per-sonalized colorectal cancer screening strategies.Methods:We performed a prospective study of the Chinese population aged 30-50 years to identify potential risk factors during a median follow-up of 9.1 years.We compared the distribution of demographic characteris-tics,lifestyle factors,dietary habits,and medical history among 222 EOCRC cases and 87,833 normal controls.Multivariate adjusted Cox hazard models were used for estimating EOCRC risks of each risk factor.Results:Our final analyses indicated that participants with a higher body mass index(HR,1.04;95%CI:1.00,1.08),regular alcohol consumption(HR,1.69;95%CI:1.12,2.91),higher intake of fish(HR,1.64;95%CI:1.01,2.67),hypertension(HR,1.99;95%CI:1.04,3.81),diabetes(HR,2.20;95%CI:1.08,4.49),and first-degree relatives with cancer(HR,1.70;95%CI:1.23,2.36)were at higher risk of EOCRC.Conclusion:We identified several modifiable as well as nonmodifiable risk factors,such as higher BMI,alcohol and fish consumption,hypertension,and diabetes,were associated with EOCRC.