Clinical trial · Observational
Exogenous and Endogenous Risk Factors for Early-onset Colorectal Cancer
Diet obEsity sMoking Epigenetics geneTics biomaRkers Physical Activity: An International Multicenter Case-control Study on Endogenous and Exogenous Risk Factors in Early-onset Colorectal Cancer
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
An increase in early-onset colorectal cancers (eoCRC), defined as a CRC before 50 years, is confirmed globally. CRC pathogenesis has been associated with several risk factors (family history, germline pathogenic variants, obesity, alcohol, physical activity, red meat, and a Western diet). Design: an international, multicenter, retrospective case-control study of prospectively enrolled patients; low-risk intervention study as it will perform a fecal occult blood test Endpoint: predictive power of a semi-quantitative food frequency questionnaire (SQFFQ) developed for eoCRC. Cases: Patients with a recent diagnosis of eoCRC (within 2 years from enrollment). Controls: matched by age (matching range ± 5 years) and sex. Healthy volunteers will be mainly enrolled among workers within the participating hospital center. The enrolled healthy volunteers will perform a fecal occult blood test. Variables of interest: age, sex, ethnicity, BMI at the time of eoCRC diagnosis and at 18 years old, country, tobacco smoking at the time of eoCRC diagnosis and at 18 years old, sitting time, TV-viewing time, moderate-to-vigorous physical activity (MVPA), waist circumference (cm), home blood pressure levels (mmHg), fasting blood glucose (mg/dl), regular consumption of aspirin/NSAID, calcium and folate supplements, oral contraceptive agents, post-menopausal hormones and years of consumptions, if the filled questionnaire reflects diet for the last 5-10 years before. Cases only: date of eoCRC diagnosis, symptoms at diagnosis, eoCRC localization, eoCRC stage, histological diagnosis, type of surgery, and date (if performed), chemotherapy and radiotherapy (if performed), vital status and duration of follow-up, family history of CRC and other cancers (uterus, ovary, stomach, small intestine, urinary tract/bladder/kidney, bile ducts, brain, pancreas, skin tumors), type of germline pathogenetic variant (if performed). Before the case-control study, three non-consecutive 24-hour Dietary Recalls (24hDRs) will validate the SQFFQ. The SQFFQ will be administered to the validation study group during three non-consecutive calls, including one non-weekday (30-minute 24-h-recall computer-aided personal interview). Primary Objective To measure the relative risk of specific dietary and lifestyle factors (smoking habit, alcohol intake, physical activity) for early-onset colorectal cancer in countries where eoCRC incidence is increasing versus stable/decreasing
Conditions
Conditions (4)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Colorectal Cancer | Malignant Colorectal Neoplasm | CURATED_BROADER | 0.80 |
| Diet Habit | — | UNRESOLVED | — |
| Early Onset Colorectal Cancer | — | UNRESOLVED | — |
| Risk Reduction | — | UNRESOLVED | — |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Semi Quantitative Food Frequency Questionnaire (SQFFQ) | Behavioral | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- label
- Early onset colorectal cancer
- description
- Patients with colorectal cancer diagnosed before the age of 50 years
- interventionNames
- Behavioral: Semi Quantitative Food Frequency Questionnaire (SQFFQ)
- label
- Control
- description
- Individuals meeting all the following: * aged \<50 years * no history of colorectal cancer * at least one negative screening test (at least a fecal occult blood test with high sensitivity)
- interventionNames
- Behavioral: Semi Quantitative Food Frequency Questionnaire (SQFFQ)
Primary outcomes (1)
- measure
- Diet and the risk of eoCRC
- timeFrame
- 10 years
- description
- To quantify the relative risk of early-onset colorectal cancer for specific dietary and lifestyle risk factors (including the risk for eoCRC for * tobacco smoking at the time of eoCRC diagnosis and at 18 years old * alcohol consumption * physical activity * sex * ethnicity * BMI at the time of eoCRC diagnosis and at 18 years old * country of origin * Daily sitting time * Daily TV-viewing time * Daily moderate-to-vigorous physical activity (MVPA) * waist circumference (cm) * home blood pressure levels (mmHg) * Fasting blood glucose (mg/dl) * Regular consumption of aspirin/NSAID * Regular consumption of calcium and folate supplements * Regular use of oral contraceptive agents and years of consumptions * Regular use of post-menopausal hormones and years of consumptions Results will be stratified by countries where the incidence of eoCRC is increasing versus stable/decreasing
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
- Maximum age
- 49 Years
Show eligibility criteria text
Inclusion Criteria: * All sexes eligible * (for Cases) eoCRC diagnosed between 18 and 49 years and confirmed by histology (biopsy or surgical specimen in case of surgery) * (for Controls) negative past and present history of cancer; negative fecal occult blood test (FOBT), or negative colonoscopy. Exclusion Criteria: * CRC diagnosed at ≥ 50 years * Diseases that can modify the dietary regimen (celiac disease, diabetes) * Diseases that are known to predispose to eoCRC (personal past or recent history of inflammatory bowel disease, past history of pelvic irradiation) * Unable to give written consents and to fill in the electronic questionnaire
References
Publications (32)
- BACKGROUNDRusso AG, Andreano A, Sartore-Bianchi A, Mauri G, Decarli A, Siena S. Increased incidence of colon cancer among individuals younger than 50 years: A 17 years analysis from the cancer registry of the municipality of Milan, Italy. Cancer Epidemiol. 2019 Jun;60:134-140. doi: 10.1016/j.canep.2019.03.015. Epub 2019 Apr 18. PMID 31005829
- BACKGROUNDZorzi M, Dal Maso L, Francisci S, Buzzoni C, Rugge M, Guzzinati S; AIRTUM Working Group. Trends of colorectal cancer incidence and mortality rates from 2003 to 2014 in Italy. Tumori. 2019 Oct;105(5):417-426. doi: 10.1177/0300891619838336. Epub 2019 Mar 27. PMID 30917756
- BACKGROUNDZorzi M, Cavestro GM, Guzzinati S, Dal Maso L, Rugge M; AIRTUM Working Group. Decline in the incidence of colorectal cancer and the associated mortality in young Italian adults. Gut. 2020 Oct;69(10):1902-1903. doi: 10.1136/gutjnl-2019-320406. Epub 2019 Dec 16. No abstract available. PMID 31843788
- BACKGROUNDWang L, Lo CH, He X, Hang D, Wang M, Wu K, Chan AT, Ogino S, Giovannucci EL, Song M. Risk Factor Profiles Differ for Cancers of Different Regions of the Colorectum. Gastroenterology. 2020 Jul;159(1):241-256.e13. doi: 10.1053/j.gastro.2020.03.054. Epub 2020 Apr 1. PMID 32247020
- BACKGROUNDZhong Y, Zhu Y, Li Q, Wang F, Ge X, Zhou G, Miao L. Association between Mediterranean diet adherence and colorectal cancer: a dose-response meta-analysis. Am J Clin Nutr. 2020 Jun 1;111(6):1214-1225. doi: 10.1093/ajcn/nqaa083. PMID 32359135
- BACKGROUNDKeum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol. 2019 Dec;16(12):713-732. doi: 10.1038/s41575-019-0189-8. Epub 2019 Aug 27. PMID 31455888
- BACKGROUNDTabung FK, Brown LS, Fung TT. Dietary Patterns and Colorectal Cancer Risk: A Review of 17 Years of Evidence (2000-2016). Curr Colorectal Cancer Rep. 2017 Dec;13(6):440-454. doi: 10.1007/s11888-017-0390-5. Epub 2017 Oct 17.