Grant Number:	5R01CA242558-05 Interpret this number
Primary Investigator:	Murphy, Caitlin
Organization:	University Of Texas Hlth Sci Ctr Houston
Project Title:	Early Life Exposures and Risk of Young-Onset Colorectal Cancer
Fiscal Year:	2023

Project Summary In contrast to dramatic declines in older populations, the incidence of colorectal cancer (CRC) has nearly doubled among younger adults since the early 1990s. Mechanisms contributing to the rising incidence of young‐onset CRC (age <50 years) have puzzled researchers for years, and to date, family history of polyps or CRC remains the only clearly established risk factor. Our prior work shows a strong birth cohort effect, whereby incidence increased markedly among persons born in or after the 1960s. Higher incidence of young‐ onset CRC among this birth cohort (approximately Generation X) implicates environmental exposures in early life. Antibiotics, cesarean delivery, birth weight, and childhood obesity – increasingly prevalent in early life – may contribute to rising incidence of young‐onset CRC. Prevalence of these environmental exposures exploded among persons born after 1960. For example, broad‐spectrum antibiotic use nearly tripled among children of the 1960s, and cesarean deliveries increased from 5% of births in 1960 to more than 30% in 2015. Mounting evidence suggests these environmental exposures alter gut microbiota, and gut microbiota may act as a key promoter of carcinogenesis, thus, mediating the relationship of environmental exposures with CRC. In the proposed project, we will generate timely evidence concerning effects of environmental exposures in early life on risk of young‐onset CRC and advance our understanding of causal mechanisms contributing to this disease. We will leverage existing data on 19,044 children enrolled in the Child Health and Development Studies (CHDS), and for whom we can ascertain young‐onset CRC diagnoses with high‐quality cancer registry data. CHDS comprises a diverse, population‐based cohort of children born in the 1960s to women receiving prenatal care in the Kaiser Foundation Health Plan (Oakland, California). CHDS collected information on prenatal visits, labor and delivery, and pediatric visits. These data do no rely on parents' or study participants' memory but excellent capture of individual‐level risk factors collected prospectively from medical records. We will append these well‐characterized data with information on family history and germline mutations by re‐ contacting CHDS participants for consent to obtain biospecimens. Our innovative use of data from an existing cohort study, combined with genomic data collected in the present day, will provide a more complete picture of young‐onset CRC than has been previously possible. We will: 1) Estimate the association of antibiotics (prenatal, perinatal, childhood), cesarean delivery, birth weight, and childhood obesity and young‐onset CRC; 2) Explore whether the association between these early life exposures and young‐onset CRC differs among those with and without a family history and/or germline mutation; and 3) Estimate the population impact of early life exposures on risk of young‐onset CRC, by synthesizing effect estimates with prevalence of early life exposures derived from population‐based surveys. By leveraging data on early life exposures from CHDS, we will generate new evidence that may ultimately be applied to CRC prevention and risk‐reduction strategies.




In utero exposure to antihistamines and risk of hepatocellular carcinoma in a multigenerational cohort.
Authors: Murphy C.C. , Seif El Dahan K. , Singal A.G. , Cirillo P.M. , Krigbaum N.Y. , Cohn B.A. .
Source: Hepatology Communications, 2024-08-01 00:00:00.0; 8(8), .
EPub date: 2024-07-22 00:00:00.0.
PMID: 39037384
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Birth Cohort Colorectal Cancer (CRC): Implications for Research and Practice.
Authors: Gupta S. , May F.P. , Kupfer S.S. , Murphy C.C. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2024 Mar; 22(3), p. 455-469.e7.
EPub date: 2023-12-09 00:00:00.0.
PMID: 38081492
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Black-White disparities in colorectal cancer outcomes: a simulation study of screening benefit.
Authors: Rutter C.M. , Nascimento de Lima P. , Maerzluft C.E. , May F.P. , Murphy C.C. .
Source: Journal Of The National Cancer Institute. Monographs, 2023-11-08 00:00:00.0; 2023(62), p. 196-203.
PMID: 37947338
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Pandemic-related changes in incidence and mortality rates of gastrointestinal cancers during 2020.
Authors: Murphy C.C. , Tavakkoli A. , Wani S. , Singal A.G. .
Source: The American Journal Of Gastroenterology, 2023-10-04 00:00:00.0; , .
EPub date: 2023-10-04 00:00:00.0.
PMID: 37791616
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Colorectal cancer screening receipt does not differ by 10-year mortality risk among older adults.
Authors: Liu P.H. , Singal A.G. , Murphy C.C. .
Source: The American Journal Of Gastroenterology, 2023-10-02 00:00:00.0; , .
EPub date: 2023-10-02 00:00:00.0.
PMID: 37782288
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Declines in Colorectal Cancer Incidence and Mortality Rates Slow Among Older Adults.
Authors: Murphy C.C. , Lee J.K. , Liang P.S. , May F.P. , Zaki T.A. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2023-06-10 00:00:00.0; , .
EPub date: 2023-06-10 00:00:00.0.
PMID: 37308035
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Survival of Middle Eastern and North African Individuals Diagnosed with Colorectal Cancer: A Population-Based Study in California.
Authors: Zaki T.A. , Ziogas A. , Chang J. , Murphy C.C. , Anton-Culver H. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2023-06-01 00:00:00.0; 32(6), p. 795-801.
PMID: 37012208
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In utero exposure to antiemetic and risk of adult-onset colorectal cancer.
Authors: Murphy C.C. , Cirillo P.M. , Krigbaum N.Y. , Singal A.G. , Cohn B.A. .
Source: Jnci Cancer Spectrum, 2023-03-01 00:00:00.0; 7(2), .
PMID: 36895101
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In-utero exposure to antibiotics and risk of colorectal cancer in a prospective cohort of 18 000 adult offspring.
Authors: Murphy C.C. , Cirillo P.M. , Krigbaum N.Y. , Singal A.G. , Jones D.P. , Zaki T. , Cohn B.A. .
Source: International Journal Of Epidemiology, 2023-01-24 00:00:00.0; , .
EPub date: 2023-01-24 00:00:00.0.
PMID: 36692207
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Stool-Based Tests Mitigate Impacts of COVID-19 on Colorectal Cancer Screening.
Authors: Liu P.H. , Singal A.G. , Murphy C.C. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2022-12-23 00:00:00.0; , .
EPub date: 2022-12-23 00:00:00.0.
PMID: 36566814
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Persistent Disparities in Colorectal Cancer Screening: A Tell-Tale Sign for Implementing New Guidelines in Younger Adults.
Authors: Liu P.H. , Sanford N.N. , Liang P.S. , Singal A.G. , Murphy C.C. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2022-09-02 00:00:00.0; 31(9), p. 1701-1709.
PMID: 35765830
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Racial and Ethnic Disparities in Early-Onset Colorectal Cancer Survival.
Authors: Zaki T.A. , Liang P.S. , May F.P. , Murphy C.C. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2022-06-16 00:00:00.0; , .
EPub date: 2022-06-16 00:00:00.0.
PMID: 35716905
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No Increase in Colorectal Cancer Screening in 2019 After American Cancer Society Recommends Starting Screening at Age 45.
Authors: Liu P.H. , Singal A.G. , Murphy C.C. .
Source: Clinical Gastroenterology And Hepatology : The Official Clinical Practice Journal Of The American Gastroenterological Association, 2022-06-11 00:00:00.0; , .
EPub date: 2022-06-11 00:00:00.0.
PMID: 35700888
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Colorectal Cancer in Younger Adults.
Authors: Dharwadkar P. , Zaki T.A. , Murphy C.C. .
Source: Hematology/oncology Clinics Of North America, 2022 06; 36(3), p. 449-470.
EPub date: 2022-05-13 00:00:00.0.
PMID: 35577711
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Increasing Incidence Rates of Colorectal Cancer at Ages 50-54 Years.
Authors: Zaki T.A. , Singal A.G. , May F.P. , Murphy C.C. .
Source: Gastroenterology, 2022 Mar; 162(3), p. 964-965.e3.
EPub date: 2021-10-29 00:00:00.0.
PMID: 34757141
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Early life: an important window of susceptibility for colorectal cancer.
Authors: Murphy C.C. , Cohn B.A. .
Source: Gastroenterology, 2022-01-07 00:00:00.0; , .
EPub date: 2022-01-07 00:00:00.0.
PMID: 35007514
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In utero exposure to 17α-hydroxyprogesterone caproate and risk of cancer in offspring.
Authors: Murphy C.C. , Cirillo P.M. , Krigbaum N.Y. , Cohn B.A. .
Source: American Journal Of Obstetrics And Gynecology, 2022 Jan; 226(1), p. 132.e1-132.e14.
EPub date: 2021-11-09 00:00:00.0.
PMID: 34767803
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Rising Early-Onset Colorectal Cancer Incidence is Not an Artifact of Increased Screening Colonoscopy Use in a Large, Diverse Healthcare System.
Authors: Lee J.K. , Merchant S.A. , Jensen C.D. , Murphy C.C. , Udaltsova N. , Corley D.A. .
Source: Gastroenterology, 2021-09-20 00:00:00.0; , .
EPub date: 2021-09-20 00:00:00.0.
PMID: 34555382
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Maternal obesity, pregnancy weight gain, and birth weight and risk of colorectal cancer.
Authors: Murphy C.C. , Cirillo P.M. , Krigbaum N.Y. , Singal A.G. , Lee M. , Zaki T. , Burstein E. , Cohn B.A. .
Source: Gut, 2021-08-24 00:00:00.0; , .
EPub date: 2021-08-24 00:00:00.0.
PMID: 34429385
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Epidemiology and Mechanisms of the Increasing Incidence of Colon and Rectal Cancers in Young Adults.
Authors: Stoffel E.M. , Murphy C.C. .
Source: Gastroenterology, 2020 01; 158(2), p. 341-353.
EPub date: 2019-08-05 00:00:00.0.
PMID: 31394082
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