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@ARTICLE{Archambault:168982,
      author       = {A. N. Archambault and Y. Lin and J. Jeon and T. A. Harrison
                      and D. T. Bishop and H. Brenner$^*$ and G. Casey and A. T.
                      Chan and J. Chang-Claude$^*$ and J. C. Figueiredo and S.
                      Gallinger and S. B. Gruber and M. J. Gunter and M.
                      Hoffmeister$^*$ and M. A. Jenkins and T. O. Keku and L. L.
                      Marchand and L. Li and V. Moreno and P. A. Newcomb and R.
                      Pai and P. S. Parfrey and G. Rennert and L. C. Sakoda and R.
                      S. Sandler and M. L. Slattery and M. Song and A. K. Win and
                      M. O. Woods and N. Murphy and P. T. Campbell and Y.-R. Su
                      and A. Zeleniuch-Jacquotte and P. S. Liang and M. Du and L.
                      Hsu and U. Peters and R. B. Hayes},
      title        = {{N}ongenetic {D}eterminants of {R}isk for {E}arly-{O}nset
                      {C}olorectal {C}ancer.},
      journal      = {JNCI cancer spectrum},
      volume       = {5},
      number       = {3},
      issn         = {2515-5091},
      address      = {Oxford},
      publisher    = {Oxford University Press},
      reportid     = {DKFZ-2021-01178},
      pages        = {pkab029},
      year         = {2021},
      abstract     = {Incidence of early-onset (younger than 50 years of age)
                      colorectal cancer (CRC) is increasing in many countries.
                      Thus, elucidating the role of traditional CRC risk factors
                      in early-onset CRC is a high priority. We sought to
                      determine whether risk factors associated with late-onset
                      CRC were also linked to early-onset CRC and whether
                      association patterns differed by anatomic subsite.Using data
                      pooled from 13 population-based studies, we studied 3767 CRC
                      cases and 4049 controls aged younger than 50 years and
                      23 437 CRC cases and 35 311 controls aged 50 years and
                      older. Using multivariable and multinomial logistic
                      regression, we estimated odds ratios (ORs) and $95\%$
                      confidence intervals (CIs) to assess the association between
                      risk factors and early-onset CRC and by anatomic
                      subsite.Early-onset CRC was associated with not regularly
                      using nonsteroidal anti-inflammatory drugs (OR = 1.43,
                      $95\%$ CI = 1.21 to 1.68), greater red meat intake (OR =
                      1.10, $95\%$ CI = 1.04 to 1.16), lower educational
                      attainment (OR = 1.10, $95\%$ CI = 1.04 to 1.16), alcohol
                      abstinence (OR = 1.23, $95\%$ CI = 1.08 to 1.39), and
                      heavier alcohol use (OR = 1.25, $95\%$ CI = 1.04 to 1.50).
                      No factors exhibited a greater excess in early-onset
                      compared with late-onset CRC. Evaluating risks by anatomic
                      subsite, we found that lower total fiber intake was linked
                      more strongly to rectal (OR = 1.30, $95\%$ CI = 1.14 to
                      1.48) than colon cancer (OR = 1.14, $95\%$ CI = 1.02 to
                      1.27; P = .04).In this large study, we identified several
                      nongenetic risk factors associated with early-onset CRC,
                      providing a basis for targeted identification of those most
                      at risk, which is imperative in mitigating the rising burden
                      of this disease.},
      cin          = {C070 / C120 / HD01 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C120-20160331 /
                      I:(DE-He78)HD01-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34041438},
      pmc          = {pmc:PMC8134523},
      doi          = {10.1093/jncics/pkab029},
      url          = {https://inrepo02.dkfz.de/record/168982},
}