Life's crucial 9, plasma proteomics, and the risk of major complications and mortality in MASLD.

Colorectal cancer (CRC) is a growing global health problem, with approximately 1.9 million new diagnoses and 1 million deaths annually. Africa is projected to face the sharpest global surge by 2050—an estimated 140% increase in new CRC cases and a 155% increase in deaths. These trends are apparent in Nigeria, Africa’s most populous nation, where most patients (88%) are diagnosed at an advanced stage, have limited treatment options, and die within 1 year of diagnosis. Recognizing these challenges, Nigeria’s Cancer Control Plan 2023-2027 and The Lancet Oncology Commission emphasize the urgent need for primary cancer prevention. While populationwide screening programs have effectively reduced CRC in high-income countries (HICs), major barriers to their implementation remain in sub-Saharan Africa, including limited infrastructure, access, and affordability. In a community-based study of 346 adults in Nigeria, only 5% of participants eligible for CRC screening had ever been screened. To design effective prevention strategies in this resource-limited setting, it is essential to identify individuals at the highest risk. Decades of research in HICs have identified a panel of CRC risk factors, including family history of cancer, height, excess body weight, physical activity, smoking, alcohol intake, diabetes, and dietary intake of certain food groups (eg, red meat), among others. However, it remains unclear whether these apply to the Nigerian population, which is typically younger, more likely to present with rectal disease, and may exhibit a 2- to 3-fold higher frequency of microsatellite instability than US patients. Furthermore, conventional risk factors, such as smoking, alcohol use, obesity, and diabetes, are far less prevalent in Nigeria.