Male sex and hispanic ethnicity are associated with increased risk of early-onset colorectal cancer

1. Male sex and Hispanic ethnicity were associated with increased risk of early-onset colorectal cancer (EOCRC).

2. Among females, higher birthweight and older paternal age were associated with increased EOCRC risk.

3. Among males, having a foreign-born mother was associated with lower EOCRC risk.

Evidence Rating Level: 3 (Average)

EOCRC is defined as CRC diagnosed among individuals <50 years of age and is the leading cause of cancer-related mortality in this population in the US, with the incidence steadily increasing. It is unclear how demographic, birth, and parental characteristics are associated with the risk of EOCRC, particularly among growing minority groups such as Hispanics. This study thus examined the association between demographic, birth, parental characteristics, and risk of EOCRC among individuals in California. This case-control study included cases born and diagnosed with EOCRC at the age of 0 to 39 years in California from 1988 through 2021. Diagnosed cases were frequency-matched to controls (1:50 case to control ratio) based on birth year. This study included 1,221 cases (mean [SD] age at diagnosis, 29.07 [5.80] years), matched to 61,050 controls. The primary outcome was incident EOCRC. In total, 44.88% identified as Hispanic, 36.45% identified as non-Hispanic White, 64.54% were US-born mothers, and of those with foreign-born mothers, 60.97% were born in Mexico. After adjusting for confounding, males had a 34% higher risk of EOCRC compared to females (OR = 1.34; 95% CI, 1.20–1.51), and Hispanic ethnicity was associated with 43% higher risk of EOCRC compared to non-Hispanic White individuals (OR = 1.34; 95% CI, 1.20–1.51). Among males, having a foreign-born mother was associated with a lower risk of EOCRC (OR = 0.79; 95% CI, 0.65–0.95). Among females, every 500-g increase in birthweight was associated with 10% increase in EOCRC risk (OR = 1.10; 95% CI, 1.01–1.21). Having a father aged ≥35 years was also associated with a higher risk of EOCRC (OR = 1.56; 95% CI, 1.08–2.25). Overall, this study found that male sex and Hispanic ethnicity were associated with increased risk of EOCRC. Among females, higher birthweight and older paternal age were also associated with increased EOCRC risk. In contrast, maternal birthplace was found to be protective against EOCRC, particularly among males. Future studies are needed to confirm these findings. 

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