TOPLINE

A large prospective cohort study of nearly 200,000 Korean adults younger than 50 years found that accelerated biological aging on routine blood tests was associated with a notably higher risk for early-onset colorectal adenocarcinoma, particularly colon adenocarcinoma.

METHODOLOGY

• Early-onset colorectal cancer (CRC) is rising worldwide, and more than half of cases are diagnosed before 45 years, the recommended screening age. Chronological age alone may therefore be an imperfect way to flag risk.
• Researchers analyzed data from a large prospective health screening cohort in Korea, including 198,491 adults younger than 50 years (mean age, 32.8 years; 52.4% men) who were free of CRC at baseline and underwent health screening between 2011 and 2021. Participants were followed for a median duration of 7.7 years.
• Biological age was estimated using the phenotypic age algorithm, which combines chronological age with nine blood markers measured in routine tests: albumin, creatinine, glucose, C-reactive protein, lymphocyte percentage, mean cell volume, red cell distribution width, alkaline phosphatase, and white blood cell count.
• Participants were grouped by how their biological age compared with the cohort average for people of the same chronological age: more than 2 years younger (decelerated), within 2 years (reference), or at least 2 years older (accelerated).
• New cases of early-onset colorectal adenocarcinoma were identified through the Korean cancer registry and grouped by location (colon or rectum) and tumor type. Early-onset colorectal neuroendocrine tumors were analyzed separately for comparison.

TAKEAWAY

• During follow-up, 127 participants developed early-onset colorectal adenocarcinoma. 
• Those in the accelerated biological aging group had a 93% higher risk for early-onset colorectal adenocarcinoma than those in the reference group (hazard ratio [HR], 1.93; 95% CI, 1.28-2.91). Each 1-unit increase in biological age acceleration was associated with a 7% higher risk.
• The association was stronger for colon adenocarcinoma (HR, 2.32; 95% CI, 1.38-3.89 for accelerated aging), whereas rectal adenocarcinoma showed no statistically significant association.
• Early-onset colorectal neuroendocrine tumors showed no consistent association with biological age acceleration, suggesting that the association may be specific to adenocarcinoma.

IN PRACTICE

"These findings suggest that biological aging measures derived from routine clinical biomarkers may help identify younger adults at elevated EOCRC-AC [early-onset colorectal adenocarcinoma] risk beyond chronological age alone," the authors wrote.

SOURCE

The study was led by Yoosoo Chang, MD, PhD, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. It was published online in Clinical Gastroenterology and Hepatology.

LIMITATIONS

Because most participants were East Asian, the findings may not apply to other populations. Few early-onset colorectal adenocarcinoma cases occurred in some subgroups and in the colon and rectum analyses, which reduced the study's ability to detect real differences. Lifestyle habits were only partly captured, and detailed information on diet and smoking was lacking, so the study could not rule out the possibility that unmeasured habits partly explained the observed association. 

DISCLOSURES

Some authors disclosed receiving grants from the National Research Foundation of Korea, the Institute for Information & Communications Technology Planning & Evaluation, and the Southampton National Institute for Health and Care Research Biomedical Research Centre. One author reported receiving research grant funding from Echosens.

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