A new study has uncovered seven risk factors for early onset colon cancer in men.
In Scotland, colorectal cancer is the third most diagnosed cancer in men after prostate cancer and lung cancer. Excluding skin cancer, it accounts for 12 per cent of all cancer cases males, according to data gathered by Public Health Information for Scotland (SCOTPHO).
While research shows that colon cancer rates and deaths are falling in those over 50, they are actually increasing in men under this age. The latest findings published in Cancer Research Prevention may help bring early diagnoses in men who are below the recommended age - 45- for colorectal cancer screenings.
Led by researcher-clinician Thomas Imperiale, M.D., of the U.S. Department of Veterans Affairs (VA), Regenstrief Institute and Indiana University School of Medicine, the study examined 600 US army veterans with non-hereditary colon or rectal cancer, as well as 2,400 VA patients across the US.
After studying health data focusing on a variety of lifestyle factors, researchers identified seven factors that raise the risk for early onset colon cancer in men as the following.
Seven risk factors for early colon cancer in men
- older age (within the 35 - to 49-year-old age range)
- no regular use of non-steroidal anti-inflammatory drugs (such as aspirin or ibuprofen)
- no regular use of statins - cholesterol lowering medications
- current alcohol use
- first or second degree relative with colorectal cancer - family history
- a higher disease burden
- connection/copay variable - a marker for socio-economic status
While the first six risk factors are universal, the final one relates medical costs paid out by US insurance companies. A co-pay means a patient will only have to pay a certain amount for healthcare, while the insurance company pays the rest.
This may be why it is considered a marker for socio-economic status among American veterans. SCOTPHO data shows that colon cancer rates and deaths are significantly higher among people living in areas of socioeconomic deprivation in Scotland.
“This study is important because it puts whether, and possibly how, to screen people who are younger than age 45 -- below the age for recommended colorectal cancer screening and have some of the risk factors we identify -- on the table for consideration for screening,” said Dr. Imperiale.
“We know that colon cancer at younger ages is on the rise, although the absolute risk is still much lower than even in the 45 - to 54-year-old age group. Nonetheless, that doesn't mean that we shouldn't be trying to identify younger people at higher risk to screen them with some modality."
“Clinicians might have a discussion with a patient and say that although screening guidelines don't kick in until age 45 and you don't have a family history, you do have some risk factors. Might you consider a noninvasive screening test?"
Dr. Imperiale added that the study helped determine what risk factors seen in older people would apply to those diagnosed with cancer at younger ages. While some factors were assigned to both age groups, others like weight were risk factors for older men only.
Using electronic health record data and national VA datasets, scientists examined sociodemographic and lifestyle factors, family and personal medical history, physical measures, vital signs, medications and laboratory values for six to 18 months.
All participants were male veterans between the ages of 35 and 49. A total of 65 percent were White and 30 percent were Black.
Initially identifying 15 variables associated with early onset colorectal cancer, researchers then condensed these to the above seven factors.
Dr. Imperiale concluded: “We don’t believe that any of these risk factors, with the exception of service-connection/copay variable, which we believe may be a proxy for income and/or socioeconomic status (and only an approximate one), are unique or specific to the veteran population.”
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