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Early-onset colorectal cancer: initial clues and current views
Lorne J Hofseth1,2,3, James R Hebert4,5,6, Anindya Chanda4,7
1Center for Colon Cancer Research, University of South Carolina, Columbia, SC, USA. hofseth@cop.sc.edu.
Nature Reviews. Gastroenterology & Hepatology
|February 23, 2020
Summary
Early-onset colorectal cancer (EOCRC) is rising, with diet, stress, and gut microbiota implicated. Research is needed to understand causes in nonobese individuals and childhood exposures.
Area of Science:
- Oncology
- Epidemiology
- Microbiology
Background:
- The incidence of early-onset colorectal cancer (EOCRC) in individuals under 50 has significantly increased.
- While environmental factors are studied, the complete causes and mechanisms of EOCRC remain unclear.
- Existing research on adiposity's role shows inconsistencies, suggesting other factors may affect nonobese individuals.
Purpose of the Study:
- To review potential risk factors and mechanisms driving EOCRC.
- To explore factors beyond adiposity that may contribute to EOCRC risk.
- To identify research gaps and methodological challenges in studying EOCRC.
Main Methods:
- Review of epidemiological studies and scientific literature.
- Analysis of environmental factors, dietary patterns, and lifestyle behaviors.
- Consideration of the gut microbiota's role in EOCRC pathogenesis.
Main Results:
- Westernized diets, stress, antibiotic use, food additives, and physical inactivity are identified as key risk factors.
- The gut microbiota is hypothesized to be central to the interplay of these risk factors.
- Childhood exposures and disease timelines present methodological challenges for research.
Conclusions:
- Factors such as diet, stress, and gut microbiome alterations are crucial in EOCRC development, potentially affecting even nonobese individuals.
- Further research is needed to elucidate the complex mechanisms and early-life origins of EOCRC.
- Addressing lifestyle and environmental factors may be key to mitigating the rising EOCRC incidence.
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