AB156. SOH26AB_0467. Social deprivation indices demonstrate a stronger correlation with epigenetic age compared to chronological age in early-onset colorectal cancer (EOCRC), particularly in stage IV disease

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Background: Social deprivation is associated with worse outcomes in colorectal cancer, but is less studied in early-onset colorectal cancer (EOCRC). One hypothesis is that the social environment may accelerate aging (AA), which can be measured using epigenetic age (EpiAge). EpiAge is considered a more accurate marker of aging than age by birth and is calculated using a validated blood-based algorithm. It has been shown to correlate strongly with age in whole body tissue/cell testing and is considered a more accurate predictor of DNA methylation. This study aimed to examine the relationship between social deprivation with EpiAge and age by birth, to better understand why it is associated with worse outcomes in EOCRC. Methods: EOCRC patients diagnosed in the Mid-West of Ireland from 2015 to 2024 (inclusive) were included. EpiAge was calculated using a validated blood-based algorithm. Social deprivation was classified using the Pobal HP Deprivation Index. Pearson and Spearman correlation coefficients were used depending on data distribution, and significance was observed at P<0.05. Results: Data on 114 patients were analysed (n=65 colon, n=49 rectal). Social deprivation correlated with EpiAge stronger than age by birth in EOCRC (r=0.97, P=0.009; r=0.09, P=0.3). EpiAge correlated stronger with social deprivation indices in colon cancer compared to rectal cancer (r=0.80, P=0.02; r=0.15, P=0.23). This relationship was also stronger in stage IV disease (r=0.7, P=0.007; r=0.49, P=0.15) compared to those treated with curative intent. Conclusions: EpiAge correlates strongly with social deprivation in EOCRC, demonstrating biological evidence of accelerated aging in this cohort as a potential aetiology and explanation of its prognostic ability.

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