TOPLINE:

Males have 34% higher risk for early-onset colorectal cancer (EOCRC) than females, while Hispanic individuals have 43% higher risk than non-Hispanic White individuals. Among females specifically, every 500-g increase in birthweight raises EOCRC risk by 10%, and having a father older than 35 years increases the risk by 56%.

METHODOLOGY:

• The relationship between demographic, birth, and parental characteristics and risk for EOCRC has not been fully elucidated, particularly among growing minority groups such as Hispanics, creating a knowledge gap that this study aimed to address through comprehensive evaluation of these factors.
• Researchers conducted a population-based nested case-control study in California, including 1221 cases of individuals diagnosed with EOCRC at age 0-39 years during 1988-2021 and 61,050 frequency-matched control individuals based on birth year.
• California birth records from 1982 to 2021 were linked with statewide cancer diagnosis data from the California Cancer Registry for 1988-2021, with control individuals randomly selected from birth records and matched 50:1 to cases.
• Demographic, birth, and parental characteristics were abstracted from birth records, including child sex, race/ethnicity, birthweight, gestational age, birth order, delivery mode, maternal age, maternal birthplace, paternal age, and parental education.
• Odds ratios (ORs) and 95% CI were estimated using multivariable logistic regression models adjusted for all demographic, birth, and parental characteristics, with year of birth included to account for matching.
• Subgroup analyses were stratified by sex, age at diagnosis (0-19 years vs 20-39 years), and Hispanic ethnicity (Hispanic vs non-Hispanic White) to identify potential differences in EOCRC etiology based on demographic factors.

TAKEAWAY:

• After multivariable adjustment, males had a 34% higher risk for EOCRC than females (OR, 1.34), and Hispanic ethnicity was associated with a 43% higher risk than non-Hispanic ethnicity (OR, 1.43).
• Having a foreign-born mother was associated with lower risk for EOCRC overall (OR, 0.85), with the protective effect particularly pronounced among males (OR, 0.79).
• Among females, every 500-g increase in birthweight was associated with 10% increased EOCRC risk (OR, 1.10), and having a father older than 35 years was associated with 56% higher risk (OR, 1.56).
• No significant associations were observed between EOCRC risk and gestational age, birth order, mode of delivery, birth plurality, maternal age, maternal education, maternal history of miscarriage or stillbirth, maternal complications during pregnancy, maternal history of cesarean section, or paternal education.

IN PRACTICE:

“High birthweight, male sex, Hispanic ethnicity, and older paternal age are potential risk factors for EOCRC. Maternal birthplace, which is associated with diet, smoking patterns, other health-promoting characteristics, may be protective against EOCRC,” the authors of the study wrote.

SOURCE:

The study was led by Sunny Siddique, MPH, PhD, Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut. It was published online in Cancer.

LIMITATIONS:

According to the authors, the subgroup analysis of individuals aged 0-19 years included only 76 cases and may be underpowered due to a smaller sample size. Approximately 70% of cases and control individuals had missing information for maternal and paternal education, though evaluation among those with complete data did not suggest an association between parental education and EOCRC risk. The authors noted potential for false positives due to evaluation of a large number of novel birth, demographic, and parental characteristics, though stepwise model selection showed similar effect estimates. There may be residual confounding from unmeasured factors such as maternal obesity, which has been shown to be associated with colorectal cancer risk in offspring. The analytic sample included cases born between 1982 and 2021 with the oldest age group being 39 years, so findings may not be applicable to a broader cohort of patients with EOCRC diagnosed between ages 40 and 49. 

DISCLOSURES:

This work received support from the National Cancer Institute through the Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship to Siddique (award number 1F31CA281335-01). Siddique also received support from the Yale Cancer Prevention and Control Training Program via a T32 award from the National Cancer Institute (award number 2T32CA250803-06). The collection of cancer incidence data received support from the California Department of Public Health, the Centers for Disease Control and Prevention’s National Program of Cancer Registries, and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program. Rong Wang, PhD, disclosed receiving grants from Flatiron Health outside the submitted work. Xiaomei Ma, PhD, disclosed receiving consultation fees from Bristol Myers Squibb outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.