Colorectal Cancer, Age, and Obesity-Related Comorbidities: A Large Database Study
Colorectal Cancer, Age, and Obesity-Related Comorbidities: A Large Database Study
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DOI：
10.1007/s10620-020-06602-x
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发表时间：
2020-09-21
影响因子：
3.1
通讯作者：
Cooper, Gregory S.
中科院分区：
文献类型：
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作者：
Elangovan, Abbinaya;Skeans, Jacob;Cooper, Gregory S.
背景与目的肥胖与结直肠癌(CRC)之间的关系在老年人中已得到很好的证实，但在年轻人群中证据有限。本研究旨在分析早发性结直肠癌(E-CRC)肥胖及其相关并发症的关系，并与晚发性结直肠癌(L-CRC)进行比较。方法对IBM Watson Health Explorys商业数据库中最近5年活跃患者的平均风险个体进行了一项回顾性横断面研究。对不同年龄段(20-39岁、40-49岁和50-74岁)的结直肠癌患者与未患结直肠癌的患者进行比较。将确诊为50岁的结直肠癌患者(E-CRC)与50岁至74岁的结直肠癌患者(L-CRC)进行比较。变量包括性别、吸烟、肥胖BMI、2型糖尿病(DM2)、高血压(HTN)和高脂血症(HLD)。由于Explorys汇总了人口层面的、未查明身份的数据，因此不需要机构审查委员会的批准。结果在37,483,140人中，确诊散发性结直肠癌162,150例。与一般人群相比，肥胖和高密度脂蛋白是各年龄段结直肠癌的独立危险因素；DM2、高脂血症和吸烟是所有年龄段男性和L结直肠癌女性的独立危险因素。与L结直肠癌患者相比，E-CRC患者肥胖相关合并症的比例较低。结论肥胖、DM2、HTN、HLD和吸烟是男性结直肠癌的独立危险因素，肥胖和HLD是女性结直肠癌的独立危险因素。这些亚群可能受益于个性化的筛查方法来检测早发性结直肠癌。
Background and Aims The association between obesity and colorectal cancer (CRC) is well established in older individuals, but evidence is limited in the younger population. The study aims to analyze the relationship of obesity and its related comorbidities in early-onset CRC (E-CRC) and compare it to late-onset CRC (L-CRC). Methods A retrospective, cross-sectional study was performed on average-risk individuals >= 20 years who were active patients in the commercial database, IBM Watson Health Explorys in the last 5 years. Individuals with CRC were compared to those without CRC across different age groups (20-39, 40-49, and 50-74 years). Individuals with CRC diagnosed < 50 years (E-CRC) were compared to those with CRC between 50 and 74 years (L-CRC). Variables included sex, smoking, obese BMI, diabetes mellitus type 2 (DM2), hypertension (HTN), and hyperlipidemia (HLD). Since Explorys aggregates population-level, de-identified data, approval from institutional review board was not required. Results Among 37,483,140 individuals, 162,150 cases of sporadic CRC were identified. Compared to the general population, obesity and HLD were independent risk factors for CRC across all age groups; DM2, HTN, and smoking were independent risk factors for CRC in men of all age groups and women with L-CRC. Compared to L-CRC, individuals with E-CRC had lower percentages of obesity-related comorbidities. Conclusion In E-CRC, obesity, DM2, HTN, HLD, and smoking are independent risk factors for CRC among men; obesity and HLD are independent risk factors for CRC in women. These subgroups may benefit from a personalized screening approach to detect early-onset CRC.