Several demographic and early-life characteristics may be associated with the risk of early-onset colorectal cancer (EOCRC), according to a population-based study of individuals born in California.
EOCRC, defined as colorectal cancer diagnosed before age 50, has increased steadily in recent decades and is now a leading cause of cancer-related death among younger adults. Understanding factors associated with risk may help inform future prevention and risk-stratification efforts.
Researchers linked California birth records with statewide cancer registry data to examine whether demographic, birth, and parental characteristics were associated with EOCRC risk. The study included 1,221 individuals diagnosed with colorectal cancer between ages 0 and 39 years and 61,050 cancer-free controls matched by birth year. Most cases were diagnosed between ages 20 and 39 years.
After adjustment for multiple demographic and parental factors, males had a 34 percent higher risk of EOCRC than females. Hispanic individuals also had a significantly higher risk than non-Hispanic White individuals. The association was most apparent among those diagnosed between ages 20 and 39 years.
The study also found that having a foreign-born mother was associated with a lower risk of EOCRC. Although the reasons for this finding remain unclear, the authors suggested it may reflect differences in lifestyle, diet, obesity rates, or other health-related factors during pregnancy.
Among females, higher birthweight and older paternal age were associated with increased EOCRC risk. Every 500g increase in birthweight was linked to a 10 percent increase in risk, while having a father aged 35 years or older was associated with a 56 percent higher risk compared with paternal age of 20–24 years. These associations were not observed in males.
No significant associations were found for gestational age, birth order, mode of delivery, multiple birth status, maternal age, maternal education, pregnancy complications, prior miscarriage or stillbirth, maternal history of cesarean delivery, or paternal education.
The findings add to growing evidence that EOCRC may be influenced by factors acting early in life, long before disease develops. Although these characteristics are not diagnostic markers, they may help researchers better understand disease etiology and identify populations at increased risk.
The authors emphasized that the study identifies associations rather than causative factors. They also noted limitations, including the lack of information on family history, genetic predisposition, maternal obesity, and other established colorectal cancer risk factors. Further studies are needed to validate the findings and investigate the biological mechanisms involved.
As EOCRC incidence continues to rise, understanding how demographic, developmental, and parental factors contribute to risk may support future strategies for earlier detection and prevention.
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