Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study

ObjectiveThis study aims to identify risk factors of colorectal cancer in a middle-aged and elder Chinese population over 45 years old and to provide evidence for preventing colorectal cancer in China.MethodThe China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative co...

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Main Authors: Lin Zhang, Yuyan Zhang, Yujia Huo, Yang Zhao, Aimin Xu, Zhining Liu, Qiaojun Hong, Huiming Tu, Junjie Huang, Li Liu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Molecular Biosciences
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Online Access:https://www.frontiersin.org/articles/10.3389/fmolb.2025.1333834/full
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author Lin Zhang
Lin Zhang
Yuyan Zhang
Yujia Huo
Yujia Huo
Yang Zhao
Aimin Xu
Zhining Liu
Qiaojun Hong
Huiming Tu
Junjie Huang
Li Liu
author_facet Lin Zhang
Lin Zhang
Yuyan Zhang
Yujia Huo
Yujia Huo
Yang Zhao
Aimin Xu
Zhining Liu
Qiaojun Hong
Huiming Tu
Junjie Huang
Li Liu
author_sort Lin Zhang
collection DOAJ
description ObjectiveThis study aims to identify risk factors of colorectal cancer in a middle-aged and elder Chinese population over 45 years old and to provide evidence for preventing colorectal cancer in China.MethodThe China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative cohort used for research on demography, lifestyle and characteristics of colorectal cancer population. The logistic regression model was used to estimate the odds ratio (OR) and corresponding confidence interval (95% CI) using the maximum likelihood method. Univariate logistic regression was performed with the ORs of each risk factor and its association with incidence of colorectal cancer. Risk factors significant in univariate logistic regression were further evaluated by multivariate logistic regression. Cox proportional hazards model estimated the hazard ratio (HR) of each risk factor and its association with incidence of colorectal cancer.ResultsIn the univariable analysis, sex (OR = 2.31, 95% CI: 1.00–5.36, p = 0.05), smoking (OR = 2.30, 95% CI: 1.03–5.13, p = 0.04), age of quit drinking (OR = 1.07, 95% CI: 1.01–1.14, p = 0.02) and chronic lung disease (OR = 2.79, 95% CI: 1.11–6.99, p = 0.03) were associated with colorectal cancer which was also included in the multivariable analysis. However, probably because of the small sample size of colorectal cancer patients, no indicator was confirmed to be risk factor of colorectal cancer in the multivariable logistic regression. The univariate analysis of the Cox model indicated that smoking (HR = 2.30, 95%: 1.03–5.13, p = 0.04) and chronic lung disease (HR = 2.79, 95%: 1.11–6.97, p = 0.03) were associated with incidence of colorectal cancer. Similar to the results of multiple linear regression, no indicator was confirmed to be risk factors of incidence of colorectal cancer in the multivariable Cox model.ConclusionIn the univariate analysis, we identified significant associations between colorectal cancer and factors such as smoking and chronic lung disease. However, these associations did not hold in the multivariate analysis due to limitations in sample size. This suggests the need for further validation of these potential risk factors in larger-scale studies.
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spelling doaj-art-e0edf43722094a249bafffc1179214682025-08-20T02:18:28ZengFrontiers Media S.A.Frontiers in Molecular Biosciences2296-889X2025-04-011210.3389/fmolb.2025.13338341333834Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal studyLin Zhang0Lin Zhang1Yuyan Zhang2Yujia Huo3Yujia Huo4Yang Zhao5Aimin Xu6Zhining Liu7Qiaojun Hong8Huiming Tu9Junjie Huang10Li Liu11The School of Public Health and Preventive Medicine, Monash University, Suzhou, ChinaSuzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, ChinaMonash University-Southeast University Joint Research Institute (Suzhou), Southeast University, Nanjing, ChinaThe School of Public Health and Preventive Medicine, Monash University, Suzhou, ChinaSuzhou Industrial Park Monash Research Institute of Science and Technology, Monash University, Suzhou, ChinaThe George Institute for Global Health, University of New South Wales, Sydney, NSW, AustraliaDepartment of Statistics, College of Big Data and Software Engineering, Zhejiang Wanli University, Ningbo, ChinaAnhui Medical University Affiliated Hospital, Hefei, ChinaDepartment of Oncology, Anhui No. 2 Provincial People’s Hospital, Hefei, ChinaDepartment of Gastroenterology, Affiliated Hospital of Jiangnan University, Wuxi, ChinaThe Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of HongKong, Shatin, China0Big Data Center, Affiliated Hospital of Jiangnan University, Wuxi, ChinaObjectiveThis study aims to identify risk factors of colorectal cancer in a middle-aged and elder Chinese population over 45 years old and to provide evidence for preventing colorectal cancer in China.MethodThe China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative cohort used for research on demography, lifestyle and characteristics of colorectal cancer population. The logistic regression model was used to estimate the odds ratio (OR) and corresponding confidence interval (95% CI) using the maximum likelihood method. Univariate logistic regression was performed with the ORs of each risk factor and its association with incidence of colorectal cancer. Risk factors significant in univariate logistic regression were further evaluated by multivariate logistic regression. Cox proportional hazards model estimated the hazard ratio (HR) of each risk factor and its association with incidence of colorectal cancer.ResultsIn the univariable analysis, sex (OR = 2.31, 95% CI: 1.00–5.36, p = 0.05), smoking (OR = 2.30, 95% CI: 1.03–5.13, p = 0.04), age of quit drinking (OR = 1.07, 95% CI: 1.01–1.14, p = 0.02) and chronic lung disease (OR = 2.79, 95% CI: 1.11–6.99, p = 0.03) were associated with colorectal cancer which was also included in the multivariable analysis. However, probably because of the small sample size of colorectal cancer patients, no indicator was confirmed to be risk factor of colorectal cancer in the multivariable logistic regression. The univariate analysis of the Cox model indicated that smoking (HR = 2.30, 95%: 1.03–5.13, p = 0.04) and chronic lung disease (HR = 2.79, 95%: 1.11–6.97, p = 0.03) were associated with incidence of colorectal cancer. Similar to the results of multiple linear regression, no indicator was confirmed to be risk factors of incidence of colorectal cancer in the multivariable Cox model.ConclusionIn the univariate analysis, we identified significant associations between colorectal cancer and factors such as smoking and chronic lung disease. However, these associations did not hold in the multivariate analysis due to limitations in sample size. This suggests the need for further validation of these potential risk factors in larger-scale studies.https://www.frontiersin.org/articles/10.3389/fmolb.2025.1333834/fullmiddle-aged and elder adultChinese populationrisk factorCHARLScolorectal caner
spellingShingle Lin Zhang
Lin Zhang
Yuyan Zhang
Yujia Huo
Yujia Huo
Yang Zhao
Aimin Xu
Zhining Liu
Qiaojun Hong
Huiming Tu
Junjie Huang
Li Liu
Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study
Frontiers in Molecular Biosciences
middle-aged and elder adult
Chinese population
risk factor
CHARLS
colorectal caner
title Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study
title_full Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study
title_fullStr Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study
title_full_unstemmed Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study
title_short Risk factors of colorectal cancer in middle-aged and elder adults in China: findings from the China health and retirement longitudinal study
title_sort risk factors of colorectal cancer in middle aged and elder adults in china findings from the china health and retirement longitudinal study
topic middle-aged and elder adult
Chinese population
risk factor
CHARLS
colorectal caner
url https://www.frontiersin.org/articles/10.3389/fmolb.2025.1333834/full
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