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Unconditional logistic regression (odds ratios (OR) and 95% confidence intervals (CI)) was used to compare risk factors by age-at-diagnoses; those diagnosed\u2009&lt;\u200950\u00a0years (EOCRC,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009288) compared to those diagnosed\u2009\u2265\u200950\u00a0years (LOCRC,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091,018), adjusting for sex, race\/ethnicity, education, smoking status, and family history of CRC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to LOCRC, EOCRC cases had higher odds of ever consuming alcohol (OR\u2009=\u20092.47, CI: 1.55\u20133.91), consuming more alcohol in their teens\/twenties than in other decades (OR\u2009=\u20091.85, CI: 1.36\u20132.51), and binge drinking (OR\u2009=\u20093.15, CI: 2.31\u20134.30). EOCRC cases were more likely to have Lynch syndrome (OR\u2009=\u20094.61, CI: 2.72\u20137.84), and report experiencing pre-diagnostic\u00a0CRC symptoms (OR\u2009=\u20096.08, CI: 3.77\u20139.82), including blood in stool (52.3 vs. 30.7%), change in bowel habits (37.2 vs. 19.8%), and bowel obstruction (13.9 vs. 7.7%). Birth weight, inflammatory bowel disease, irritable bowel syndrome, and sex did not differ by age-at-diagnosis. However, when birthweight was compared between the youngest EOCRC to the oldest LOCRC cases (&lt;\u200940 vs.\u2009\u2265\u200965\u00a0years), odds of birthweight of\u2009&lt;\u20096lbs was higher in the youngest cases (OR: 2.15, CI: 0.95\u20134.87).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Alcohol consumption, consuming the most alcohol in one\u2019s teens\/twenties, binge drinking, having Lynch syndrome, and pre-diagnostic\u00a0CRC symptoms were more associated with EOCRC than LOCRC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10552-026-02208-2","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T05:02:46Z","timestamp":1783746166000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Early and late-onset colorectal cancers: a case-case comparison of risk factors"],"prefix":"10.1007","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1466-9357","authenticated-orcid":false,"given":"Samantha","family":"Rees","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Pearlman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Electra D.","family":"Paskett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter G.","family":"Shields","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Hampel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo L.","family":"Freudenheim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"2208_CR1","unstructured":"American Cancer Society. 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