Risk Factors for Early-Onset Colorectal Cancer: A Systematic Literature Review
Main Article Content
The incidence of early-onset colorectal cancer (EOCRC) among individuals younger than 50 years has continued to increase, although its underlying etiological factors remain incompletely understood. This study aimed to identify the most consistently reported risk factors for EOCRC and examine their interrelationships based on current scientific evidence. A systematic literature review was conducted involving 27 primary research articles published between 2021 and 2026. The literature search and study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Methodological quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools, and thematic relationships were mapped using VOSviewer. The findings identified four major categories of EOCRC risk factors. The first category comprised general and abdominal obesity, metabolic syndrome, type 2 diabetes mellitus, hyperglycemia, hypertriglyceridemia, hypertension, and inflammatory bowel disease. The second category included alcohol consumption, sugar-sweetened beverage intake, proinflammatory and hyperinsulinemic dietary patterns, smoking, and sedentary behavior, while vitamin D intake was associated with a potentially protective effect. The third category involved antibiotic exposure, with associations varying according to age at exposure, duration of use, antibiotic spectrum, and tumor subsite. The fourth category encompassed family history, polygenic risk scores, genetic variants, accelerated biological aging, and birth-related and parental characteristics. VOSviewer analysis identified ten clusters highlighting interrelationships among metabolic, lifestyle, microbiome-related, genetic, and early-life factors. The review concluded that obesity, metabolic disorders, inflammatory bowel disease, unhealthy dietary patterns, and family history were the most consistently reported risk factors for EOCRC, whereas associations involving antibiotic exposure and birth-related characteristics warranted further targeted investigation.
Keywords:
Early-Onset Colorectal Cancer, Metabolic Disorders, Dietary Patterns, Gut Microbiota, Genetic Susceptibility
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