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Colorectal Cancer, Age, and Obesity-Related Comorbidities: A Large Database Study

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Abstract

Background and Aims

The association between obesity and colorectal cancer (CRC) is well established in older individuals, but evidence is limited in the younger population. The study aims to analyze the relationship of obesity and its related comorbidities in early-onset CRC (E-CRC) and compare it to late-onset CRC (L-CRC).

Methods

A retrospective, cross-sectional study was performed on average-risk individuals ≥ 20 years who were active patients in the commercial database, IBM Watson Health Explorys in the last 5 years. Individuals with CRC were compared to those without CRC across different age groups (20–39, 40–49, and 50–74 years). Individuals with CRC diagnosed < 50 years (E-CRC) were compared to those with CRC between 50 and 74 years (L-CRC). Variables included sex, smoking, obese BMI, diabetes mellitus type 2 (DM2), hypertension (HTN), and hyperlipidemia (HLD). Since Explorys aggregates population-level, de-identified data, approval from institutional review board was not required.

Results

Among 37,483,140 individuals, 162,150 cases of sporadic CRC were identified. Compared to the general population, obesity and HLD were independent risk factors for CRC across all age groups; DM2, HTN, and smoking were independent risk factors for CRC in men of all age groups and women with L-CRC. Compared to L-CRC, individuals with E-CRC had lower percentages of obesity-related comorbidities.

Conclusion

In E-CRC, obesity, DM2, HTN, HLD, and smoking are independent risk factors for CRC among men; obesity and HLD are independent risk factors for CRC in women. These subgroups may benefit from a personalized screening approach to detect early-onset CRC.

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Funding

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Authors and Affiliations

  1. Department of Internal Medicine-Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Abbinaya Elangovan & David C. Kaelber

  2. Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Jacob Skeans

  3. Department of Gastroenterology and Hepatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Marc Landsman

  4. Department of Internal Medicine, Saint Vincent Hospital, Worchester, MA, USA

    Sajjadh M. J. Ali

  5. Texas A&M University, College Station, TX, USA

    Arvind Ganesan Elangovan

  6. Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA

    Dalbir S. Sandhu

  7. Division of Gastroenterology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Wearn 244, Cleveland, OH, 44106-5066, USA

    Gregory S. Cooper

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  1. Abbinaya Elangovan
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  2. Jacob Skeans
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  3. Marc Landsman
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  4. Sajjadh M. J. Ali
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  5. Arvind Ganesan Elangovan
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  7. Dalbir S. Sandhu
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  8. Gregory S. Cooper
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Contributions

AE, JS and GS contributed to the conception and design of the study. AE collected data. AGE and SMJ analyzed and interpreted the data. AE and JS wrote the initial draft. All authors contributed, revised and approved the final draft.

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Correspondence to Gregory S. Cooper.

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Elangovan, A., Skeans, J., Landsman, M. et al. Colorectal Cancer, Age, and Obesity-Related Comorbidities: A Large Database Study. Dig Dis Sci 66, 3156–3163 (2021). https://doi.org/10.1007/s10620-020-06602-x

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  • DOI: https://doi.org/10.1007/s10620-020-06602-x

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