Colorectal Cancer Prevention

38 - Factors Associated With Early (<50 Years) and Late Onset (≥50 Years) Colorectal Cancer: A Population-Based National Study

Tuesday, October 9
2:25 PM - 2:35 PM
Location: Terrace Ballroom 4 (level 400)

Category: Colorectal Cancer Prevention
Abbinaya Elangovan, MD1, Jacob M. Skeans, MD1, Dalbir S. Sandhu, MD1, David C. Kaelber, MD, MPH, PhD1, Gregory Cooper, MD2
1Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH; 2University Hospitals Cleveland Medical Center, Cleveland, OH

Introduction: The incidence of colorectal cancer (CRC) under 50 years of age has shown a rising trend in the past few decades. Understanding the characteristics of individuals with CRC in the younger and older age groups will aid in identifying the ‘population at risk’ among the unscreened population less than 50 years.

Methods: De-identified electronic health record data of 56 million individuals (Caucasians 57%, African Americans 11%, 2% Asians and 2% Hispanics) across 26 healthcare networks from 1999-2017 was analyzed using Explorys database. Using SNOMED-CT codes, cases of CRC < and ≥50 years of age were identified after excluding hereditary cancer syndromes and characteristics such as sex, race, BMI, Crohn’s disease, ulcerative colitis, diabetes mellitus type 2 (DM2), hypertension and hyperlipidemia were compared using chi-square testing. Further, the cohorts were compared with individuals without CRC in the same age group excluding inflammatory bowel diseases and the prevalence trend over the last 15 years was analyzed. IRB approval was not required.

Results: 28,570 cases of CRC and 6140 cases (21%) of rectal cancer were diagnosed < 50 years with a racial distribution of 72.5% Caucasians and 9.2 % African Americans. When compared to the people with CRC over 50 years, people with CRC diagnosed under 50 years were more likely to be female, obese or overweight, tobacco users, have Crohn’s disease, ulcerative colitis and less likely to have essential hypertension and hyperlipidemia.

However, when compared to the people without CRC, individuals with CRC were associated with higher odds of overweight/obesity, diabetes mellitus type 2, hypertension, hyperlipidemia and the association was stronger in CRC under 50 years than their older counterparts.

Discussion: This study highlights the difference in the association of metabolic syndrome between CRC diagnosed under 50 and over 50 years of age in a large study population. Individuals with CRC under 50 years significantly vary from the general population with a higher prevalence of metabolic syndrome. Further studies to establish the cause-effect relationship will help to determine the usefulness of targeted CRC screening under 50 years in individuals with one or more components of metabolic syndrome.

Table 1: CRC < 50 Vs CRC ≥ 50. All P values are < .0001 except * where P=0.01
Table 2: CRC compared to the general population. All P values are < .0001 except * where P=0.0035
Image 1: Trend of CRC in the last 15 years

Disclosures:
Abbinaya Elangovan indicated no relevant financial relationships.
Jacob Skeans indicated no relevant financial relationships.
Dalbir Sandhu indicated no relevant financial relationships.
David Kaelber indicated no relevant financial relationships.
Gregory Cooper indicated no relevant financial relationships.

Abbinaya Elangovan

Resident, Medicine- Pediatrics
Case Western University/ MetroHealth Medical Center
Cleveland, OH

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