Abstract 3739: Are young adults with colorectal cancer doing enough to stay healthy

Background Colorectal cancer (CRC) arises from complex interactions between inherited susceptibility and environmental factors. Modifiable risk factors include smoking, obesity, physical inactivity, increased red meat intake, and excessive alcohol consumption. The dramatic rise in CRC incidence currently observed among young adults (aged 18-50) has been attributed to obesity and other lifestyle factors, but the health behavior of young patients is unknown. The purpose of this study was to examine the health behavior of young adults with CRC in order to identify key areas for risk modification. Methods Between 2011- 2014, 201 young adults diagnosed with CRC without an inherited polyposis phenotype were prospectively enrolled into an institutional protocol. Participants’ health and lifestyle behavior (during the preceding month) were prospectively assessed via a self-administered questionnaire, which was modified from the National Cancer Institute CRC Risk Assessment Tool. Patients whose CRC showed evidence of DNA mismatch repair deficiency (dMMR) vs. not were compared in a subgroup analysis. Results The median age at CRC diagnosis was 40.5, 52% of the tumors arose from the colon and 48% in the rectum. The majority (87%) of the patients were White; 118 (59%) were female; and 86 (43%) had a bachelor or higher degree. Two in three of these young adults (134, 67%) were overweight or obese, with 22% meeting the definition for obesity (BMI 30-34.9), and 17% meeting that for morbidly obesity (BMI >35). The physical activity level recommended by the US Preventive Task Force (2.5 hours of moderate and 1.25 hours of vigorous activity/week) were met by only 142 (71%) and 118 (59%) of the young adults for moderate and vigorous activities respectively. Only half (107, 53%) of the young adults consumed 5 servings of fruits and vegetables per week, a minimum recommendation from the American Cancer Society. Finally, one in ten (21, 10%) of the young adults were active smokers; and only 135 (67%) had never smoked. Among the 45 (22%) self-reported former smokers, 29 (64%) had smoked for >10 years prior to quitting. In subgroup analysis, no statistically significant differences in health behavior were detected between patients with (n = 91) vs. without (n = 110) dMMR CRCs. Conclusions Significant gaps were identified between the health behaviors of young CRC patients when compared to standard US recommendations. The high prevalence of potentially modifiable risk factors indicates that increased resources should be devoted to targeted health counseling and behavioral interventions. Their institution may help curtail the currently rising burden of CRC among young adults. Citation Format: Y. Nancy You, Eduardo Vilar, Amanda Cuddy, Caiqian Wu, Patrick M. Lynch, Cathy Eng, Miguel Rodriguez-Bigas, George Chang. Are young adults with colorectal cancer doing enough to stay healthy. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3739. doi:10.1158/1538-7445.AM2015-3739