By Patty Kim - July 06, 2023
Colorectal cancer cases and deaths in older people are decreasing, partly because of widespread screening to remove precancerous polyps, according to the American Cancer Society. However, colorectal cancer cases in younger people are on the rise.
A new study in Cancer Prevention Research has identified seven risk factors that are associated with an increased risk of early onset colorectal cancer in men.
Using the U.S. Department of Veterans Affairs database, researchers identified 956 men ages 35 to 49 who had been diagnosed with nonhereditary colorectal cancer between 2008 and 2015. Of those, 600 met the criteria to be included in the study. They were matched with 1,200 controls who had colonoscopies but did not have colorectal cancer, as well as 1,200 controls who had not had a colonoscopy.
Researchers examined age; cohabitation; employment; body mass index; cancer in first- or second-degree relatives; comorbidities; alcohol use; genetic and acquired disorders involving elevated lipid levels; and use of statins, nonsteroidal anti-inflammatory drugs (NSAID) and multivitamins.
From this group, they narrowed it to seven factors associated with an increased risk of early onset colorectal cancer:
- Older age between 35 to 49
- No regular use of nonsteroidal anti-inflammatory drugs such as aspirin or ibuprofen
- No regular use of statins to lower cholesterol
- Current use of alcohol
- First- or second-degree relative with colorectal cancer
- Higher disease burden
- Service connection or co-pay variable (researchers considered this an approximation of income or socioeconomic status)
Study authors note that the risk factors that carried the most weight are having a first- or second-degree relative with colorectal cancer, not taking a statin and not being on NSAIDs.
"Awareness of risk factors would encourage primary care doctors to have these conversations with patients to increase screening."- Dr. Amalia Stefanou, Gastrointestinal Oncology Department
“Identifying these risk factors can help physicians encourage individuals 45 to 50 to have screening scopes. This is important because the guidelines of starting screening exams at 45 is new and some patients and primary care providers don’t yet broadly accept these recommendations,” said Dr. Amalia Stefanou, surgical oncologist in the Gastrointestinal Oncology Department at Moffitt Cancer Center. “Also, awareness of risk factors would encourage primary care doctors to have these conversations with patients to increase screening.”
So what can you do to lower your risk of developing colorectal cancer?
Everyone 45 and older should get screened. Colonoscopy is the gold standard, but talk to your doctor about which test is right for you.
If you have a strong family history of colorectal polyps or cancer, talk with your doctor about your risk.
Maintaining a healthy weight and increasing the amount and intensity of your physical activity may help lower your risk. When it comes to diet, limit red and processed meats, and eat more fruits, vegetables and whole grains. It’s best not to drink alcohol, but if you do, women should limit it to one drink per day and men to two drinks per day.
Quitting smoking can help lower your risk of colorectal and many other types of cancers.
Colorectal cancer typically does not cause noticeable symptoms in its early stages. However, talk to your doctor if you notice:
- Unusual changes in bowel habits for several days, such as narrow stools, diarrhea or constipation
- A feeling that the bowel does not empty completely
- Very dark or bright red stools, which may indicate blood
- Unexplained weight loss
- Abdominal pain or cramping
“Unfortunately we don’t know why more younger people are developing colorectal cancer. But we encourage everyone to stay vigilant with their health and talk to their doctor about their personal risk of developing the disease,” Stefanou said.