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Colorectal cancer: Red meat also puts young people at risk

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WE RETURN to talk about the link between red meat consumption and colorectal cancer, but this time in the under 50s. To bring new data on a long-investigated and still debated issue is an analysis conducted in the US by NYU Langone Health, financed by the National Cancer Institute and published in the JNCI Cancer Spectrum, which explored the non-genetic factors associated with the increased risk of this neoplasm in younger people.

High consumption of red meat and alcohol among the risk factors for young people

Using data collected in 13 population studies, the researchers compared over 3,700 cases of colorectal cancer with 4,000 control cases (people who did not develop the disease) in the under 50s. at the age of 50, comparing more than 23,400 patients with more than 35,300 control cases.

Among the youngest, colorectal cancer was associated with irregular use of aspirin, increased consumption of red meat, low education, excessive alcohol consumption, as well as – to note – total abstinence from alcohol. In addition, lower fiber intake was more strongly associated with rectal cancer than with colon cancer. There are also other factors for which an association has been shown, including diabetes and a low intake of folate (B vitamins) and calcium, as well as fiber. On the other hand, no correlation was found either with the body mass index or with smoking, unlike what emerges for the over 50s.

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Cases doubled in the last 40 years in the US

The study starts from a finding: that overseas the incidence of colorectal cancers under the age of 50 (early-onset colorectal cancer – EOCRC) has almost doubled in the last 30 years, going from 8.6 to 13.1 cases for one hundred thousand inhabitants between 1992 and 2013. Rectal cancers have increased in this age group – according to researchers from NYU Langone Health: about one out of 10 diagnoses, in fact, involved people under the age of 50. The curve grows for those born in the 1960s onwards, both in the US and Canada, Australia and Japan. From those same years – the authors note – there have also been major changes in diet, with a decrease in the consumption of vegetables (except potatoes) and fruit, and an increase in the consumption of processed foods and soft drinks.

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Much research in recent years has explored the role of diet and certain foods in particular, as well as overweight, obesity and a sedentary lifestyle. A recent meta-analysis published in Jama Open, for example, reviewed the scientific evidence on the correlations between cancer risk, foods and types of diets, defining as “convincing” those with high consumption of red meat and alcohol, while a high intake of fibers proved to be protective.

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Another study conducted by the International Agency for Research on Cancer (IARC) and published in BMC Medicine found that the role of weight and body mass index (BMI) is different for men and women. A high BMI appears to be more dangerous for the former, while an excessive waist-to-hip ratio (a measure of abdominal fat, which is calculated by dividing the measurement of the waist by the circumference at the hip) would be for the latter.

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Italy goes against the trend: cases are decreasing

In the US, the American Cancer Society has already recommended bringing the start of screening to 45 instead of 50, and even in Europe the data on the increase in the incidence of under 30s are well known. In this context, our country is an exception. The number of cases of colorectal cancer is in fact decreasing: it has dropped by as much as 20% in the last 7 years, from 53,000 to 43,000 a year. So much so that oncologists speak of a ‘colorectal case’. According to experts, these data are due to the diffusion of screening that allows the identification and removal of polyps before they develop into actual tumors, thus serving as a preventive tool, as well as early diagnosis.

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The decrease, however, is not so evident under 40. It must be said that in this age group cases are rare: they represent just about 5% of all diagnoses (2300 cases estimated in 2020) and for the most part they are linked to genetic syndromes.

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