Early-onset colorectal cancer: initial clues and current views.,Nature Reviews Gastroenterology & Hepatology

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Early-onset colorectal cancer: initial clues and current views.
Nature Reviews Gastroenterology & Hepatology ( IF 45.9 ) Pub Date : 2020-02-21 , DOI: 10.1038/s41575-019-0253-4
Lorne J Hofseth _{1,

2,

3} , James R Hebert _{1,

2,

4} , Anindya Chanda _{1,

5} , Hexin Chen _{1,

6} , Bryan L Love _{1,

7} , Maria M Pena _{1,

6} , E Angela Murphy _{1,

8} , Mathew Sajish _{1,

3} , Amit Sheth _{1,

9} , Phillip J Buckhaults _{1,

3} , Franklin G Berger _{1,

6}

Affiliation

Over the past several decades, the incidence of early-onset colorectal cancer (EOCRC; in patients <50 years old) has increased at an alarming rate. Although robust and scientifically rigorous epidemiological studies have sifted out environmental elements linked to EOCRC, our knowledge of the causes and mechanisms of this disease is far from complete. Here, we highlight potential risk factors and putative mechanisms that drive EOCRC and suggest likely areas for fruitful research. In addition, we identify inconsistencies in the evidence implicating a strong effect of increased adiposity and suggest that certain behaviours (such as diet and stress) might place nonobese and otherwise healthy people at risk of this disease. Key risk factors are reviewed, including the global westernization of diets (usually involving a high intake of red and processed meats, high-fructose corn syrup and unhealthy cooking methods), stress, antibiotics, synthetic food dyes, monosodium glutamate, titanium dioxide, and physical inactivity and/or sedentary behaviour. The gut microbiota is probably at the crossroads of these risk factors and EOCRC. The time course of the disease and the fact that relevant exposures probably occur in childhood raise important methodological issues that are also discussed.

中文翻译：

早发性结直肠癌：初步线索和当前观点。

在过去的几十年里，早发性结直肠癌（EOCRC；<50 岁的患者）的发病率以惊人的速度增加。尽管强有力且科学严谨的流行病学研究已经筛选出了与 EOCRC 相关的环境因素，但我们对这种疾病的原因和机制的了解还远远不够。在这里，我们强调了推动 EOCRC 的潜在风险因素和推定机制，并提出了可能进行富有成效的研究的领域。此外，我们发现证据中存在不一致之处，表明肥胖增加具有强烈影响，并表明某些行为（例如饮食和压力）可能会使非肥胖者和其他健康人面临患这种疾病的风险。回顾了关键的风险因素，包括全球饮食西化（通常涉及大量摄入红肉和加工肉类、高果糖玉米糖浆和不健康的烹饪方法）、压力、抗生素、合成食用色素、味精、二氧化钛和缺乏身体活动和/或久坐行为。肠道微生物群可能处于这些危险因素和 EOCRC 的十字路口。该疾病的时间进程以及相关暴露可能发生在儿童时期的事实提出了重要的方法学问题，也进行了讨论。

更新日期：2020-02-21

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