Allostatic load as a potential pathway linking exposomic risk to early-onset cancer: a matched case-control study in the All of Us Research Program

Background: Early-onset cancer (EoC) incidence is rising worldwide, yet risk models built on isolated exposures or rare pathogenic variants capture little of the cumulative environmental burden experienced by younger adults. Allostatic load (AL), the cumulative physiological burden of chronic stress, can be measured from routine laboratory values and vital signs and is a candidate biological pathway linking environmental exposures to carcinogenesis. Methods: We conducted a 1:4 matched case-control study nested within the NIH All of Us Research Program, including 7,550 participants and 1,510 ca

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