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Behavioral Risk Factors and Risk of Early-Onset Colorectal Cancer: Review of the Mechanistic and Observational Evidence

  • Nutrition and Nutritional Interventions in Colorectal Cancer (K Wu, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Purpose of the Review

The goal of this review is to summarize recent evidence linking behavioral risk factors to early-onset colorectal cancer (EO-CRC) as the incidence continues to rise by 2% annually in the USA. The potential mechanisms linking these risk factors to EO-CRC are also discussed.

Recent Findings

Obesity and sedentary behavior have been associated with an increased risk of EO-CRC in women through a large cohort study, while the data is inconclusive for men. Diabetes was also associated with an increased risk of EO-CRC in a large Swedish cohort study. While the evidence for metabolic syndrome and diet comes from cross-sectional studies, they still point to an association with EO-CRC. The mechanisms underlying these risk factors include inflammation, gut dysbiosis, and aberrant mitogenic signaling.

Summary

The etiology of EO-CRC likely involves a multifactorial mechanism that will require a multidisciplinary approach. Existing consortia and new data harmonization of multiple studies will be useful in re-evaluating the role of established lifestyle/genetic risk factors of CRC in EO-CRC. Future investigations should prospectively collect information on exposures and biospecimens, particularly during early life, to further elucidate risk factors and contributors to the rising incidence of EO-CRC.

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Funding

This work was supported by US National Institutes of Health (NIH) grant P30CA09182 and R37CA246175. Dr. Otegbeye was supported by T32CA009621. Dr. Fritz was supported by T32 DK007130. Dr. Liao was supported by China Scholarship Council.

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Authors and Affiliations

  1. Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Ebunoluwa E. Otegbeye

  2. Division of Gastroenterology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

    Cassandra D. L. Fritz & Yin Cao

  3. Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA

    Jingwen Liao & Yin Cao

  4. Scientific Research Center, Guangzhou Sport University, Guangzhou, China

    Jingwen Liao

  5. Department of Surgery, Section of Colon and Rectal Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Radhika K. Smith

  6. Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA

    Yin Cao

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  1. Ebunoluwa E. Otegbeye
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  2. Cassandra D. L. Fritz
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  4. Radhika K. Smith
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Correspondence to Yin Cao.

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Conflict of Interest

Radhika Smith declares no potential conflicts of interest. Ebunoluwa Otegbeye reports grants from the National Cancer Institute, during the conduct of the study. Cassandra Fritz reports grants from the National Institute of Diabetes and Digestive Kidney Diseases, during the conduct of the study. Jingwen Liao reports grants from the China Scholarship Council, outside the submitted work. Yin Cao reports grants from P30CA09182 and R37CA246175, during the conduct of the study.

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This article is part of the Topical Collection on Nutrition and Nutritional Interventions in Colorectal Cancer

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Otegbeye, E.E., Fritz, C.D., Liao, J. et al. Behavioral Risk Factors and Risk of Early-Onset Colorectal Cancer: Review of the Mechanistic and Observational Evidence. Curr Colorectal Cancer Rep 17, 43–53 (2021). https://doi.org/10.1007/s11888-021-00465-8

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