The incidence of colorectal cancer (CRC) has historically been the highest among Western, high-income countries but is now increasing globally beyond these regions. Early-onset CRC (diagnosed before the age of 50 years) has been the main driver of this rise, and risk factors including dietary and lifestyle aspects, the gut microbiota and environmental contaminants have been proposed to underlie these epidemiological trends. The authors of this Review discuss the available evidence on these risk factors, highlighting how the under-representation of non-Western populations in these studies is limiting progress.
- David J. Lee
- Aparna Parikh
- Andrew T. Chan