B0099 - Excess Dietary Intake May Increase the Risk of Early Colon Cancer Pathogenesis

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Jay B. Patel, MD

Temple University Hospital
Philadelphia, PA

Jay B. Patel, MD¹, Rishabh Khatri, MD¹, Jun Song, MD¹, Frank Friedenberg, MD, MS²
¹Temple University Hospital, Philadelphia, PA; ²Lewis Katz School of Medicine at Temple University, Philadelphia, PA

Introduction: Although non-modifiable factors such as age, sex, and race have been associated with increased risk of developing colon cancer, there are limited studies investigating modifiable factors. Some studies have shown fiber and calcium to be protective, while processed meats and alcohol to be risk factors. The data, however, remains controversial. The aims of this study are to 1) re-evaluate the epidemiology of colon cancer and 2) explore the nutritional status of those with early colon cancer diagnosis.

Methods: The National Health and Nutrition Examination Survey (NHANES) is a survey designed to assess the health and nutritional status of adults and children across the United States (US). Nutritional information was collected via a 24-hour diet recall, and those with reliable recall were included in the study. We combined demographic and nutritional datasets from NHANES during 2007-2016 and identified patients who self-reported a diagnosis of colon cancer. The sample size was appropriately weighted and stratified into 2 cohorts: age < 45 years vs age ≥ 45 years. SPSS was used for analysis.

Results: There were 5,767,593 self-reported cases of colon cancer in the US from 2007-2016 with reliable nutritional recall. Demographic data stratified by cohort is outlined in table 1 along with caloric and dietary intake. The average age of colon cancer diagnosis was 56.5 ± 15.3 years of which 19.4% were diagnosed early (age < 45). Univariate analysis showed those with early diagnosis had higher calorie (p< 0.001), fiber (p< 0.001), calcium (p< 0.001), caffeine (p< 0.001), and alcohol consumption (p< 0.001) than those diagnosed over 45. After controlling for BMI, race, sex, education, and income using logistic regression, we found that patients with higher caloric intake (≥ 2000 kcal) were more likely to be diagnosed with early onset colon cancer (OR: 3.81, 95% CI: 3.79-3.82).

Discussion: There were on average 576,759 reported cases of colon cancer per year in the US of which approximately 1/5^th were diagnosed before 45. Females, non-Hispanic whites, and higher education/income were associated with early colon cancer diagnosis possibly due to earlier screening. Contrary to other studies, higher fiber and calcium intake did not appear to be protective. However, those with early diagnosis did have higher alcohol intake. Our data suggests those with high caloric intake, a modifiable risk factor, increases the odds of developing early cancer by over threefold, perhaps due to chronic underlying inflammation.

			Colon Cancer Diagnosis ≥ 45 years	Colon Cancer Diagnosis < 45 years	Average	P-value
Sex	Male (%)		83.8%	16.2%	-	P< 0.001
Sex	Female (%)		78.2%	21.8%	-	P< 0.001
Race	Non-Hispanic White (%)		78.3%	21.7%	-	P< 0.001
	Non-Hispanic Black (%)		89.5%	10.5%	-
	Hispanic (%)		95.9%	4.1%	-
	Other (%)		100%	0%	-
Education Level	Less than 9^th Grade (%)		80.6%	19.4%	-	P< 0.001
	9-12^th Grade (%)		87.0%	13.0%	-
	High School Graduate (%)		89.8%	10.2%	-
	AA Degree or Some College (%)		79.1%	20.9%	-
	College Graduate (%)		72.4%	27.6%	-
Ratio of Family Income to Poverty Level (FIP)	FIP ≥ 1 (%)		78.3%	21.7%	-	P< 0.001
Ratio of Family Income to Poverty Level (FIP)	FIP < 1 (%)		88.2%	11.8%	-	P< 0.001
BMI (kg/m²)			29.9	31.4	30.2	P< 0.001
BMI		BMI ≥ 25	79.7%	20.3%	-	P< 0.001
BMI		BMI < 25	83.6%	16.4%	-	P< 0.001
Total Caloric Intake (kcal)			1679.1 ± 654.1	2177.6 ± 1092.3	1775.6 ± 784.0	P< 0.001
Total Caloric Intake		Kcal ≥ 2000	68.4%	31.6%	-	P< 0.001
Total Caloric Intake		Kcal < 2000	86.3%	13.7%	-	P< 0.001
Total Sugar (gm)			94.2 ± 69.7	122.9 ± 150.8	99.8 ± 91.9	P< 0.001
Total Fat (gm)			62.5 ± 28.8	90.7 ± 64.9	68.0 ± 40.1	P< 0.001
Dietary Fiber (gm)			14.3 ± 8.0	16.7 ± 10.5	14.7 ± 8.6	P< 0.001
Calcium (mg)			825.1 ± 537.5	980.1 ± 560.8	855.1 ± 545.6	P< 0.001
Caffeine (mg)			193.0 ± 177.4	284.0 ± 262.3	210.6 ± 200.0	P< 0.001
Alcohol (gm)			4.7 ± 14.3	9.0 ± 35.9	5.5 ± 20.4	P< 0.001

Table: Table 1: Demographic and Dietary Breakdown in Patients Diagnosed with Colon Cancer

Disclosures:

Jay Patel indicated no relevant financial relationships.

Rishabh Khatri indicated no relevant financial relationships.

Jun Song indicated no relevant financial relationships.

Frank Friedenberg indicated no relevant financial relationships.

Jay B. Patel, MD¹, Rishabh Khatri, MD¹, Jun Song, MD¹, Frank Friedenberg, MD, MS². B0099 - Excess Dietary Intake May Increase the Risk of Early Colon Cancer Pathogenesis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.