Cesarean Delivery Associated With Early-Onset Colorectal Cancer in Women

Cesarean Delivery Associated With Early-Onset Colorectal Cancer in Women

Douglas K. Rex, MD, MASGE, reviewing Cao Y, et al. JAMA Netw Open 2023 Apr 27.

Birth by cesarean delivery has been associated with intestinal dysbiosis in childhood. This study is a population-based, nationwide, case-control study from Sweden involving 564 cases of early-onset colorectal cancer (EOCRC), matched with 2180 individuals without colorectal cancer. The mean age of patients was 33 years.

The overall risk of EOCRC in cases was not increased, with an adjusted odds ratio (aOR) of 1.28 (95% confidence interval, 0.91-1.79), but the risk was significantly higher in females (aOR, 1.62) versus males born via cesarean delivery.

Douglas K. Rex, MD, FASGE


Apparently, the risk of some other conditions that have been associated with cesarean delivery (eg, asthma) is seen only in females, suggesting an interaction between sex hormones, microbial signaling, and the protective and immune functions of the mucosa.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Cao Y, Nguyen LH, Tica S, et al. Evaluation of birth by Cesarean delivery and development of early-onset colorectal cancer. JAMA Netw Open 2023;6:e2310316. (https://doi.org/10.1001/jamanetworkopen.2023.10316)

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