Skip to main content
SpringerLink
Log in

Risk factors for young-onset colorectal cancer

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

We investigated risk factors for colorectal cancer in early-onset cancers, to provide quantitative estimates for major selected risk factors.

Methods

We analyzed data from three Italian and Swiss case–control studies conducted between 1985 and 2009, including 329 colorectal cancer cases and 1,361 controls aged ≤45 years. We computed odds ratios (ORs) from unconditional logistic regression models, adjusted for major confounding factors.

Results

The OR of young-onset colorectal cancer was 4.50 for family history of colorectal cancer in first-degree relatives, the association being higher in subjects with affected siblings (OR 11.68) than parents (OR 3.75). The ORs of young-onset colorectal cancer were 1.56 for ≥14 drinks/week of alcohol, 1.56 for the highest tertile of processed meat, 0.40 for vegetables, 0.75 for fruit, and 0.78 for fish intake. Among micronutrients, the ORs were 0.52 for β-carotene, 0.68 for vitamin C, 0.38 for vitamin E, and 0.59 for folate. No significant associations emerged for physical activity, overweight, and diabetes.

Conclusions

This study—the largest on young-onset colorectal cancer—confirms that several recognized risk factors for colorectal cancer are also relevant determinants of young-onset colorectal cancer. Family history of colorectal cancer in particular is a stronger risk factor in young subjects, as compared to middle age and elderly ones.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Boyle P, Ferlay J (2005) Cancer incidence and mortality in Europe, 2004. Ann Oncol 16:481–488

    Article  PubMed  CAS  Google Scholar 

  2. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90

    Article  PubMed  Google Scholar 

  3. Giovannucci E, Wu K (2006) Cancers of the colon and rectum. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention, 3rd edn. Oxford University Press, New York

    Google Scholar 

  4. World Cancer Research Fund and American Institute for Cancer Research (2007) Food, nutrition, physical activity and the prevention of cancer: a global perspective. AICR, Washington, DC

    Google Scholar 

  5. Fernandez E, Gallus S, La Vecchia C, Talamini R, Negri E, Franceschi S (2004) Family history and environmental risk factors for colon cancer. Cancer Epidemiol Biomarkers Prev 13:658–661

    PubMed  Google Scholar 

  6. Tavani A, Braga C, La Vecchia C, Conti E, Filiberti R, Montella M, Amadori D, Russo A, Franceschi S (1999) Physical activity and risk of cancers of the colon and rectum: an Italian case–control study. Br J Cancer 79:1912–1916

    Article  PubMed  CAS  Google Scholar 

  7. La Vecchia C, Negri E, Decarli A, Franceschi S (1997) Diabetes mellitus and colorectal cancer risk. Cancer Epidemiol Biomarkers Prev 6:1007–1010

    PubMed  Google Scholar 

  8. Franceschi S, Favero A, La Vecchia C, Negri E, Conti E, Montella M, Giacosa A, Nanni O, Decarli A (1997) Food groups and risk of colorectal cancer in Italy. Int J Cancer 72:56–61

    Article  PubMed  CAS  Google Scholar 

  9. Ferraroni M, La Vecchia C, D’Avanzo B, Negri E, Franceschi S, Decarli A (1994) Selected micronutrient intake and the risk of colorectal cancer. Br J Cancer 70:1150–1155

    Article  PubMed  CAS  Google Scholar 

  10. La Vecchia C, Negri E, Pelucchi C, Franceschi S (2002) Dietary folate and colorectal cancer. Int J Cancer 102:545–547

    Article  PubMed  Google Scholar 

  11. La Vecchia C, Braga C, Negri E, Franceschi S, Russo A, Conti E, Falcini F, Giacosa A, Montella M, Decarli A (1997) Intake of selected micronutrients and risk of colorectal cancer. Int J Cancer 73:525–530

    Article  PubMed  Google Scholar 

  12. Franceschi S, La Vecchia C, Russo A, Favero A, Negri E, Conti E, Montella M, Filiberti R, Amadori D, Decarli A (1998) Macronutrient intake and risk of colorectal cancer in Italy. Int J Cancer 76:321–324

    Article  PubMed  CAS  Google Scholar 

  13. Siegel RL, Jemal A, Ward EM (2009) Increase in incidence of colorectal cancer among young men and women in the United States. Cancer Epidemiol Biomarkers Prev 18:1695–1698

    Article  PubMed  Google Scholar 

  14. You YN, Xing Y, Feig BW, Chang GJ, Cormier JN (2012) Young-onset colorectal cancer: is it time to pay attention? Arch Intern Med 172:287–289

    Article  PubMed  Google Scholar 

  15. O’Connell JB, Maggard MA, Liu JH, Etzioni DA, Livingston EH, Ko CY (2003) Rates of colon and rectal cancers are increasing in young adults. Am Surg 69:866–872

    PubMed  Google Scholar 

  16. Imperiale TF, Kahi CJ, Stuart JS, Qi R, Born LJ, Glowinski EA, Rex DK (2008) Risk factors for advanced sporadic colorectal neoplasia in persons younger than age 50. Cancer Detect Prev 32:33–38

    Article  PubMed  Google Scholar 

  17. La Vecchia C, D’Avanzo B, Negri E, Franceschi S (1991) History of selected diseases and the risk of colorectal cancer. Eur J Cancer 27:582–586

    Article  PubMed  Google Scholar 

  18. Negri E, Bosetti C, La Vecchia C, Levi F, Tomei F, Franceschi S (1999) Allergy and other selected diseases and risk of colorectal cancer. Eur J Cancer 35:1838–1841

    Article  PubMed  CAS  Google Scholar 

  19. Levi F, Pasche C, La Vecchia C, Lucchini F, Franceschi S (1999) Food groups and colorectal cancer risk. Br J Cancer 79:1283–1287

    Article  PubMed  CAS  Google Scholar 

  20. Franceschi S, Barbone F, Negri E, Decarli A, Ferraroni M, Filiberti R, Giacosa A, Gnagnarella P, Nanni O, Salvini S et al (1995) Reproducibility of an Italian food frequency questionnaire for cancer studies. Results for specific nutrients. Ann Epidemiol 5:69–75

    Article  PubMed  CAS  Google Scholar 

  21. Franceschi S, Negri E, Salvini S, Decarli A, Ferraroni M, Filiberti R, Giacosa A, Talamini R, Nanni O, Panarello G et al (1993) Reproducibility of an Italian food frequency questionnaire for cancer studies: results for specific food items. Eur J Cancer 29A:2298–2305

    Article  PubMed  CAS  Google Scholar 

  22. Decarli A, Franceschi S, Ferraroni M, Gnagnarella P, Parpinel MT, La Vecchia C, Negri E, Salvini S, Falcini F, Giacosa A (1996) Validation of a food-frequency questionnaire to assess dietary intakes in cancer studies in Italy. Results for specific nutrients. Ann Epidemiol 6:110–118

    Article  PubMed  CAS  Google Scholar 

  23. Salvini S (1998) Banca dati di composizione degli alimenti per studi epidemiologici in Italia. Istituito Europeo di Oncologia, Italia

    Google Scholar 

  24. Breslow NE, Day NE (1980) Statistical methods in cancer research, vol I. The analysis of case–control studies. IARC Sci Publ No. 32. IARC, Lyon, France

  25. Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27

    PubMed  CAS  Google Scholar 

  26. Butterworth AS, Higgins JP, Pharoah P (2006) Relative and absolute risk of colorectal cancer for individuals with a family history: a meta-analysis. Eur J Cancer 42:216–227

    Article  PubMed  Google Scholar 

  27. Negri E, Braga C, La Vecchia C, Franceschi S, Filiberti R, Montella M, Falcini F, Conti E, Talamini R (1998) Family history of cancer and risk of colorectal cancer in Italy. Br J Cancer 77:174–179

    Article  PubMed  CAS  Google Scholar 

  28. Johns LE, Kee F, Collins BJ, Patterson CC, Houlston RS (2002) Colorectal cancer mortality in first-degree relatives of early-onset colorectal cancer cases. Dis Colon Rectum 45:681–686

    Article  PubMed  Google Scholar 

  29. Johns LE, Houlston RS (2001) A systematic review and meta-analysis of familial colorectal cancer risk. Am J Gastroenterol 96:2992–3003

    Article  PubMed  CAS  Google Scholar 

  30. Fedirko V, Tramacere I, Bagnardi V, Rota M, Scotti L, Islami F, Negri E, Straif K, Romieu I, La Vecchia C, Boffetta P, Jenab M (2011) Alcohol drinking and colorectal cancer risk: an overall and dose-response meta-analysis of published studies. Ann Oncol 22:1958–1972

    Article  PubMed  CAS  Google Scholar 

  31. Acott AA, Theus SA, Marchant-Miros KE, Mancino AT (2008) Association of tobacco and alcohol use with earlier development of colorectal cancer: should we modify screening guidelines? Am J Surg 196:915–918 discussion 918–919

    Article  PubMed  CAS  Google Scholar 

  32. Aune D, Lau R, Chan DS, Vieira R, Greenwood DC, Kampman E, Norat T (2011) Nonlinear reduction in risk for colorectal cancer by fruit and vegetable intake based on meta-analysis of prospective studies. Gastroenterology 141:106–118

    Article  PubMed  Google Scholar 

  33. Fernandez E, Chatenoud L, La Vecchia C, Negri E, Franceschi S (1999) Fish consumption and cancer risk. Am J Clin Nutr 70:85–90

    PubMed  CAS  Google Scholar 

  34. Huxley RR, Ansary-Moghaddam A, Clifton P, Czernichow S, Parr CL, Woodward M (2009) The impact of dietary and lifestyle risk factors on risk of colorectal cancer: a quantitative overview of the epidemiological evidence. Int J Cancer 125:171–180

    Article  PubMed  CAS  Google Scholar 

  35. Harriss DJ, Atkinson G, Batterham A, George K, Cable NT, Reilly T, Haboubi N, Renehan AG (2009) Lifestyle factors and colorectal cancer risk (2): a systematic review and meta-analysis of associations with leisure-time physical activity. Colorectal Dis 11:689–701

    Article  PubMed  CAS  Google Scholar 

  36. Spence RR, Heesch KC, Brown WJ (2009) A systematic review of the association between physical activity and colorectal cancer risk. Scand J Med Sci Sports 19:764–781

    Article  PubMed  CAS  Google Scholar 

  37. Ning Y, Wang L, Giovannucci EL (2010) A quantitative analysis of body mass index and colorectal cancer: findings from 56 observational studies. Obes Rev 11:19–30

    Article  PubMed  CAS  Google Scholar 

  38. Jiang Y, Ben Q, Shen H, Lu W, Zhang Y, Zhu J (2011) Diabetes mellitus and incidence and mortality of colorectal cancer: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol 26:863–876

    Article  PubMed  Google Scholar 

  39. La Vecchia C (2011) Diabetes mellitus, medications for type 2 diabetes mellitus, and cancer risk. Metabolism 60:1357–1358

    Article  PubMed  Google Scholar 

  40. Chen HF, Chen P, Su YH, Su HF, Li CY (2012) Age- and sex-specific risks of colorectal cancers in diabetic patients. Tohoku J Exp Med 226:259–265

    Article  PubMed  Google Scholar 

  41. Giovannucci E (1995) Insulin and colon cancer. Cancer Causes Control 6:164–179

    Article  PubMed  CAS  Google Scholar 

  42. Renehan A, Smith U, Kirkman MS (2010) Linking diabetes and cancer: a consensus on complexity. Lancet 375:2201–2202

    Article  PubMed  Google Scholar 

  43. D’Avanzo B, La Vecchia C, Katsouyanni K, Negri E, Trichopoulos D (1997) An assessment, and reproducibility of food frequency data provided by hospital controls. Eur J Cancer Prev 6:288–293

    Article  PubMed  Google Scholar 

  44. Ferraroni M, Decarli A, Franceschi S, La Vecchia C, Enard L, Negri E, Parpinel M, Salvini S (1996) Validity and reproducibility of alcohol consumption in Italy. Int J Epidemiol 25:775–782

    Article  PubMed  CAS  Google Scholar 

  45. Bravi F, Bosetti C, Negri E, Lagiou P, La Vecchia C (2007) Family history of cancer provided by hospital controls was satisfactorily reliable. J Clin Epidemiol 60:171–175

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the Italian Association for Cancer Research (AIRC), Milan, Italy (Grant No. 10068), and by the Swiss League and Research against Cancer/Oncosuisse (Grant No. KFS-700, OCS-1633). The authors thank Mrs. I Garimoldi for editorial assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Istituto di Ricerche Farmacologiche “Mario Negri”, Via Giuseppe La Masa 19, 20156, Milan, Italy

    Valentina Rosato, Cristina Bosetti, Eva Negri & Carlo La Vecchia

  2. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy

    Valentina Rosato, Antonella Zucchetto & Carlo La Vecchia

  3. Cancer Epidemiology Unit and Registre Vaudois des Tumeurs, Institut de Médecine Sociale et Préventive (IUMSP), Lausanne University Hospital, Lausanne, Switzerland

    Fabio Levi

  4. Unit of Epidemiology and Biostatistics, Centro di Riferimento Oncologico, IRCCS, Aviano, PN, Italy

    Jerry Polesel & Antonella Zucchetto

Authors
  1. Valentina Rosato
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cristina Bosetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fabio Levi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jerry Polesel
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonella Zucchetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eva Negri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carlo La Vecchia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cristina Bosetti.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rosato, V., Bosetti, C., Levi, F. et al. Risk factors for young-onset colorectal cancer. Cancer Causes Control 24, 335–341 (2013). https://doi.org/10.1007/s10552-012-0119-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-012-0119-3

Keywords

Search

Navigation