Systematic Reviews and Meta-analysesRisk Factors for Early-Onset Colorectal Cancer: A Systematic Review and Meta-analysis
Section snippets
Literature Search, Eligibility Criteria, and Screening
The protocol for this systematic review and meta-analysis was registered with PROSPERO (CRD42020185557) and was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses13 and Meta-analysis of Observational Studies in Epidemiology recommendations.14 We systematically searched MEDLINE and Embase databases from inception to August 5, 2020 with a search strategy that was developed by D.E.O and R.L.S. in collaboration with a research librarian at
Study Inclusion and Characteristics of Included Studies
In total, 3304 unique articles were identified during the initial literature search, of which 177 articles plus 7 additional studies from reference lists underwent full-text review. After full-text review, a total of 20 studies examining at least one risk factor for EoCRC were retained, and 14 of these studies were included in the meta-analysis. The most common reasons for exclusion during the full-text review were lack of relevance (n = 82), incorrect study population (n = 31), or
Discussion
In this systematic review and meta-analysis, male sex, Caucasian ethnicity, CRC history in a first-degree relative, hyperlipidemia, obesity, and alcohol consumption were all significantly associated with a higher risk of developing EoCRC. Smoking was a suggestive but statistically non-significant risk factor. With the exception of alcohol consumption, there was considerable heterogeneity among included studies. Other potential risk factors that were less studied included ulcerative colitis,
CRediT Authorship Contributions
Dylan E. O’Sullivan, PhD (Conceptualization: Lead; Data curation: Lead; Formal analysis: Lead; Methodology: Lead; Visualization: Lead; Writing – original draft: Lead)
Robert Liam Sutherland (Conceptualization: Equal; Data curation: Lead; Formal analysis: Supporting; Methodology: Supporting; Writing – review & editing: Equal)
Susanna Town (Conceptualization: Supporting; Data curation: Lead; Formal analysis: Supporting; Methodology: Supporting; Writing – review & editing: Equal)
Kristian Chow
References (51)
- et al.
The incidence of young-onset colorectal cancer in Canada continues to increase
Cancer Epidemiol
(2020) - et al.
Racial disparities in incidence of young-onset colorectal cancer and patient survival
Gastroenterology
(2019) - et al.
AGA clinical practice update on young adult-onset colorectal cancer diagnosis and management: expert review
Clin Gastroenterol Hepatol
(2020) - et al.
Risk factors for early-onset colorectal cancer
Gastroenterology
(2020) - et al.
Family history associates with increased risk of colorectal cancer in patients with inflammatory bowel diseases
Clin Gastroenterol Hepatol
(2019) - et al.
Effects of family history on relative and absolute risks for colorectal cancer: a systematic review and meta-analysis
Clin Gastroenterol Hepatol
(2019) - et al.
Increasing colorectal cancer incidence trends among younger adults in Canada
Prev Med
(2017) - et al.
Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012
Int J Cancer
(2015) - et al.
Colorectal cancer in young adults
Current Treatment Options in Gastroenterology
(2019) - et al.
Colorectal cancer incidence patterns in the United States, 1974–2013. JNCI
Journal of the National Cancer Institute
(2017)
Global increasing incidence of young-onset colorectal cancer across 5 continents: a joinpoint regression analysis of 1,922,167 cases
Cancer Epidemiol Biomarkers Prev
Trends in the epidemiology of young-onset colorectal cancer: a worldwide systematic review
BMC Cancer
Early-onset colorectal cancer in young individuals
Molecular Oncology
Prevalence and spectrum of germline cancer susceptibility gene mutations among patients with early-onset colorectal cancer
JAMA Oncol
Rising incidence of early-onset colorectal cancer: a call to action
Nature Reviews Clinical Oncology
Risk factors associated with young-onset colorectal adenomas and cancer: a systematic review and meta-analysis of observational research
Cancer Control
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
PLoS Med
Meta-analysis of observational studies in epidemiology: a proposal for reporting—Meta-analysis of Observational Studies in Epidemiology (MOOSE) group
JAMA
Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? a systematic review
BMC Public Health
Bias in meta-analysis detected by a simple, graphical test
BMJ
Risk factors for young-onset colorectal cancer
Cancer Causes Control
Risk factors associated with early-onset colorectal cancer
Clin Gastroenterol Hepatol
Obesity is an initiator of colon adenomas but not a promoter of colorectal cancer in the Black Women’s Health Study
Cancer Causes Control
Colorectal cancer, age, and obesity-related comorbidities: a large database study
Dig Dis Sci
Cited by (106)
Precision Oncology in Gastrointestinal and Colorectal Cancer Surgery
2024, Surgical Oncology Clinics of North AmericaTracing the Pathways From Cardiovascular Disease to Cancer: The Unseen Link
2023, JACC: CardioOncologyAssociation of diabetes mellitus with early-onset colorectal cancer: A systematic review and meta-analysis of 19 studies including 10 million individuals and 30,000 events
2023, Diabetes and Metabolic Syndrome: Clinical Research and Reviews
Conflicts of interest The authors disclose no conflicts.
Funding Dylan O’Sullivan is supported by a Canadian Institutes of Health Research (CIHR) Postdoctoral Fellowship.
This article has an accompanying continuing medical education activity, also eligible for MOC credit on page e1500. Upon completion of this activity, successful learners will be able to, 1) Identify potential risk factors for early-onset colorectal cancer; and, 2) Explain the importance of establishing risk factors for this unique patient population.