Colorectal Cancer Risk Factors in Adults in Nigeria.
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Alatise Olusegun Isaac, Peeri Noah Charles, Abdulkareem Fatimah Biade, Badejo Olawale Ayodele, Gali Bata Mtaku, Oludara Mobolaji, Okereke Chukwuma Eze, Olatoke Samuel Adegboyega, Ademakinwa Oluwabusayomi Roseline, Alabi Adewumi, Aderounmu Adewale, Adeomi Adeleye, Mohammed Tajudeen, Adegboyega Olukayode, Adisa Adewale, Ajewole Omolola, Famurewa Olusola Comfort, Agodirin Sulaiman Olayide, Ariyibi Olufemi, Nggada Haruna Asura, Babatunde Olusegun Joshua, Badmos Kabir, Balogun Olanrewaju Samuel, Bamidele Christopher Oluwasesan, Batta Cephas Shallangwa, Betiku Omolade Adefolabi, Bojuwoye Matthew Olumuyiwa, Choonawala Naqiya Rahil, Cookey Cara, Daji Feyisayo Yvonne, Egberongbe Adedeji, Esan Oluwaseun, Folaranmi Olaleke Oluwasegun, Fasiku Olusola Kayode, Fatusi Adesegun, Fodero Ryan, Francis Adepoju Oluseyi, Gallagher Grace, Habeeb Muhammed Y M, Shittu Habeeb Abdulrasheed, Iasonos Alexia, Ige Oluwasuyi Emmanuel, Ikujenlola Abiodun Victor, Igetei Rufina, Jackman Julia M, Kahn Rivka, Katung Aba, Koiki Mariam Adenike, Komolafe Akinwumi O, Lawrence Abraham Pavino, Lawal AbdulRazzak, Lawal Nafisat Olayinka Olatunde, Makanjuola Ayomide, Mobolaji Jacob, Omodele Foluso, Na'aya Habila Ulea, Nganjiwa Usman Samuel, Njokanma Iloba, Nuhu Ali, Nwachukwu Emmanella, O'Connell Kelli, Odunafolabi Tunde, Ogunleye Samson Oluwagbemiga, Olaofe Olaejirinde Olaniyi, Olcese Cristina, Ologunagba Peter Olufemi, Olokoba Abdulfatai, Olasehinde Olalekan, Olajide Thomas Olagboyega, Osinowo Adedapo Olumide, Omoyiola Oluwatosin Zainab, Omisore Adeleye Dorcas, Onyekwere Charles, Owoade Israel Adeyemi, Oyesegun Rasaaq, Samson Marguerite L, Sanni Ayodele, Sharma Avinash, Sowunmi Anthonia, Sulaiman Abdullateef Temitope, Adebukola Ojajuni Titilope, Wuraola Funmilola, Adeleye Adeoluwa Oluwaseyi, Adewunmi Olayinka Lukman, Zarami Abba Bukar, Kingham T Peter, Du Mengmeng
Аннотация
OBJECTIVE: To assess whether 13 CRC risk factors identified in high-income populations are associated with CRC in adults in Nigeria.
DESIGN, SETTING, AND PARTICIPANTS: This multicenter case-control study was conducted in 6 hospitals across 3 of Nigeria's 6 geopolitical zones, with recruitment from April 2020 to September 2024. Participants were patients newly diagnosed with CRC and cancer-free controls matched on age, sex, location, education, and recruitment site. Data were analyzed from April 2023 to November 2025.
EXPOSURES: Family history of cancer, anthropometric factors (adult height, body mass index [BMI], and somatotype or body size over the life course), physical activity, and dietary and lifestyle factors (processed meat, red meat, fruit, vegetables, fiber, alcohol, smoking, and diabetes).
MAIN OUTCOMES AND MEASURES: The associations of risk factors with CRC were assessed using odds ratios (ORs) and 95% CIs, estimated using multivariable unconditional logistic regression.
RESULTS: Among 2063 participants (1103 [53.5%] male; median [IQR] age, 54 [42-64] years) enrolled, most had secondary education or higher (1756 participants [85.2%]), lived in urban areas (1817 participants [88.1%]), and were Yoruba (1524 participants [73.9%]). Cases were older than controls (median [IQR] age, 56 [45-66] vs 52 [41-63] years) but were otherwise similar. Family history of cancer (OR, 1.55; 95% CI, 1.06-2.26), adult height (OR per 5-cm increase, 1.09; 95% CI, 1.00-1.20), body size or type over the life course (tertile 3 vs tertile 1: OR, 1.88; 95% CI, 1.30-2.72), and processed meat intake (lowest vs highest tertile of intake: OR, 1.43; 95% CI, 1.07-1.91) were positively associated with CRC risk, and an inverse U-shaped association was identified between physical activity and CRC risk (OR vs first quartile of activity, quartile 2: 0.63; 95% CI, 0.44-0.88; quartile 3: 0.52; 95% CI, 0.34-0.79; quartile 4: 0.77; 95% CI, 0.58-1.02), consistent with data from high-income populations. BMI was inversely associated with CRC risk (OR vs BMI 18.5-24.9, BMI <18.5: 2.63; 95% CI, 1.79-3.86; BMI ≥30: 0.42; 95% CI, 0.28-0.63), likely reflecting prediagnostic weight loss. No associations with diabetes, smoking, or intakes of red meat, fruit, vegetables, fiber, or alcohol were observed, likely due to low prevalence or variability.
CONCLUSIONS AND RELEVANCE: This case-control study of CRC risk factors in adults in Nigeria found CRC risk patterns similar to those observed in high-income populations. These insights offer immediate opportunity to tailor education, prevention, and early detection in the region, especially as economic development leads to lifestyles more similar to high-income populations. These data provide a foundation for prospective research and investigations in other African populations.