New Prediction Model Estimates Risk of Early-Onset Colorectal Cancer

Researchers at Cleveland Clinic have developed a groundbreaking prediction model aimed at assessing the risk of early-onset colorectal cancer and advanced precancerous polyps among adults under the age of 45. This innovative study has been published in the journal Digestive Diseases and Sciences.

The standard guideline suggests that individuals at average risk should begin screening for colorectal cancer at age 45. However, recent statistics reveal that nearly half of those diagnosed with early-onset colorectal cancer are younger than this age threshold. According to the American Cancer Society, colorectal cancer is the leading cause of cancer-related deaths for men under 50 and the second leading cause for women in the same age group.

Colorectal cancer typically arises from polyps--abnormal growths on the inner lining of the colon or rectum. Various factors contribute to the increased likelihood of developing this form of cancer, prompting the need for a reliable risk prediction model.

The research team identified four significant risk factors correlated with early-onset colorectal cancer and precancerous polyps: a family history of colorectal cancer, body mass index (BMI), gender, and smoking habits. By utilizing these factors, the newly developed prediction score can estimate the probability of early-onset colorectal cancer and advanced precancerous polyps in individuals younger than 45.

The model indicates that individuals who score 9 or higher (on a scale of 12) have an over 14% likelihood of possessing cancer or advanced precancerous lesions. This score can aid healthcare providers in determining high-risk patients who would benefit from earlier screening interventions.

In the study, 9,446 patients aged 18 to 44 who underwent colonoscopies at Cleveland Clinic between January 2011 and December 2021 were analyzed. Of these, 39% were male and 61% were female, with an average BMI of 28.7, categorizing most participants as overweight. A significant majority, about 80.3%, reported no family history of colorectal cancer. Additionally, 39.7% indicated they were current or former tobacco users, while 70.9% reported alcohol use.

Among the study participants, 346 individuals were diagnosed with early-onset colorectal cancer or advanced precancerous polyps, while a control group of 9,100 was established, which included 88.4% of participants with no lesions and 11.6% with non-advanced precancerous lesions.

The researchers constructed the risk prediction model based on the associations found between the identified risk factors and the presence of cancerous or advanced precancerous lesions. This model provides an essential tool for personalized screening recommendations for younger adults, who are often overlooked in standard screening protocols.

Looking ahead, the lead researcher plans to expand this study by incorporating additional research sites, further enhancing the understanding of colorectal cancer risks in younger populations.