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Updated: Jul 16, 2026
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Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Metabolic and Laboratory Biomarkers in Early-Onset Versus Late-Onset Colorectal Cancer: A Case-Control Study
Mohamed H Eldesouki1, Ahmed E Salem2, Youssef Hafez3
1Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ 07102, USA.
Cancers
|July 15, 2026
Summary
Early-onset colorectal cancer (EOCRC) presents with distinct metabolic and inflammatory abnormalities compared to late-onset disease. Key EOCRC associations include severe obesity, microcytosis, low ferritin, and elevated C-reactive protein.
Area of Science:
- Oncology
- Gastroenterology
- Metabolic Syndrome
Background:
- Rising incidence of early-onset colorectal cancer (EOCRC) necessitates understanding its unique risk factors.
- Metabolic, inflammatory, and laboratory abnormalities' roles in EOCRC versus late-onset colorectal cancer (LOCRC) are not fully defined.
- Distinguishing antecedent risk from occult cancer indicators is crucial.
Purpose of the Study:
- To compare clinical, metabolic, and laboratory abnormalities between EOCRC and LOCRC.
- To investigate prediagnostic associations in EOCRC and LOCRC.
- To identify distinct phenotypes differentiating EOCRC from LOCRC.
Main Methods:
- Matched case-control study utilizing the TriNetX US Network (2010-2023).
- Exclusion of patients with prior malignancy, IBD, hereditary CRC risk, or prior colectomy.
- Conditional logistic regression with Bonferroni correction to analyze clinical, metabolic, and laboratory features.
Main Results:
- EOCRC more frequently presented with rectal bleeding, abdominal pain, diarrhea, anemia, and weight loss.
- Strongest EOCRC associations: severe obesity (aOR 2.61), microcytosis (aOR 2.29), low ferritin (aOR 2.11), elevated CRP (aOR 1.87).
- Obesity, metabolic syndrome, and MASH remained more strongly associated with EOCRC than LOCRC.
Conclusions:
- EOCRC exhibits a distinct clinical-metabolic phenotype with more pronounced abnormalities than LOCRC.
- Findings suggest hypothesis-generating prediagnostic associations.
- These associations are not validated predictors or causal risk factors.
