ArticleCancer causes & control : CCC2026
Lifestyle and metabolic determinants of early- and late-onset colorectal cancer: insights from a tertiary medical center in Alabama.
Article in Cancer causes & control : CCC, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeEarly-onset colorectal cancer (EOCRC, < 50 years) is rising in the United States, whereas late-onset CRC (LOCRC, ≥ 50 years) is declining. Fewer studies have examined association between risk factors and age at colorectal (CRC) diagnosis by race. Hence, we investigated whether associations between lifestyle and clinical risk factors and age at CRC diagnosis differed by race.
methodsRetrospective study conducted between 2010 and 2023 using data from a tertiary medical center in Alabama. Exposure included lifestyle factors-smoking status, and body mass index; clinical factors-type 2 diabetes (T2D), hypertension, and hyperlipidemia. Outcome was age at CRC diagnosis categorized as LOCRC and EOCRC. Multivariable logistic regression was used to examine association between lifestyle and clinical risk factors with age at CRC diagnosis after controlling for race, sex, and marital status. Race-stratified analyses were conducted.
resultsAmong 3,209 CRC patients, 54.1% were male, 71.4% White, and 55.8% were married. LOCRC was diagnosed in 81.2%. Patients who were former smokers (OR: 1.89; 95% CI: 1.50, 2.39), had T2D (OR: 1.92; 95% CI: 1.44, 2.57), hypertension (OR: 2.46; 95% CI: 1.65, 3.66), and hyperlipidemia (OR: 3.32; 95% CI: 2.35, 4.70) had higher odds of LOCRC, whereas obesity (OR: 0.61; 95% CI: 0.48, 0.77) had lower odds of LOCRC compared to EOCRC. Hypertension showed significant association with LOCRC in White patients. Hyperlipidemia showed stronger association with LOCRC in Black patients.
conclusionObesity was more prevalent in EOCRC patients and hence these differences should be considered in development of age-stratified screening and prevention strategies.
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