1. Slides last updated: March 2015 CRC: RISK FACTORS

2. Lifestyle-related risk factors in CRC 1,2 Diets that are high in red meats and processed meats -Conversely, diets that are high in vegetables, fruits and whole grains have been linked with a decreased risk of CRC Physical inactivity Obesity/high body mass index Long-term smoking Heavy use of alcohol 1.American Cancer Society. Colorectal Cancer Detailed Guide, 2014. Available online from http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf, last accessed on 17/03/2015. 2.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines on Colon Cancer. Version 2.2015. Available online from http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf, last accessed on 17/03/2015.

3. Personal and family history-related risk factors in CRC 1,2 Personal history of CRC or adenomas Personal history of inflammatory bowel disease Family history of CRC or adenomas -Screening for CRC before the age of 50 may be an option Inherited syndromes -5-10% of CRC patients have inherited gene mutations -Includes familial adenomatous polyposis (FAP), hereditary non- polyposis colon cancer (HNPCC, or Lynch syndrome), Turcot syndrome, Peutz-Jeghers syndrome and MUTYH-associated polyposis 1.American Cancer Society. Colorectal Cancer Detailed Guide, 2014. Available online from http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf, last accessed on 17/03/2015. 2.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines on Colon Cancer. Version 2.2015. Available online from http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf, last accessed on 17/03/2015. 3.Migliore L, et al. J Biomed Biotechnol 2011;Article ID 792362. The majority of CRC cases are sporadic; only 25% of CRC cases have a family history 3

4. Other risk factors in CRC 1,2 Age -90% of people diagnosed with CRC are ≥50 years old Type 2 diabetes Metabolic syndrome -Combination of diabetes, high blood pressure and obesity Certain racial and ethnic backgrounds -African-Americans have the highest CRC rates in the US -Ashkenazi Jews (of Eastern European descent) have one of the highest CRC risks of any ethnic group in the world; several gene mutations associated with CRC risk have been found within this group 1.American Cancer Society. Colorectal Cancer Detailed Guide, 2014. Available online from http://www.cancer.org/acs/groups/cid/documents/webcontent/003096-pdf.pdf, last accessed on 17/03/2015. 2.National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines on Colon Cancer. Version 2.2015. Available online from http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf, last accessed on 17/03/2015.