BOSTON — Research on Colorectal Cancer in Younger Adults

As colorectal cancer rates climb among younger adults, a group of researchers in Boston has uncovered some intriguing differences in tumor cells that might lead to new treatment options.

The findings are encouraging for survivors like Kristen Vincent from Orleans, who received a stage 3 colorectal cancer diagnosis at just 37 years old. She recalls, “I was actually staged on my youngest daughter’s second birthday. So, I found out that I had stage three cancer on her second birthday, and that was my biggest fear: missing their lives.”

Vincent’s treatment journey included 28 days of radiation, surgery, eight rounds of chemotherapy, and 11 months with an ileostomy bag. Despite the challenges, she focused on maintaining a positive mindset throughout her ordeal. “Every day I would tell myself, cancer is not going to kill me today,” she said.

Today, Vincent has enjoyed five years without any signs of cancer. She has also participated in the Pan-Mass Challenge, raising over $25,000 for cancer research at Dana-Farber, the institution she credits for her recovery.

According to the American Cancer Society, colorectal cancer rates among people under 50 have been rising nearly 3% each year lately, making it the leading cause of cancer-related deaths in that age group.

Researchers from Mass General Brigham, Dana-Farber Cancer Institute, and the Broad Institute produced a study that looks into the increasing diagnosis rates of colorectal cancer among younger patients. Dr. Ana Anderson, a senior co-author of the study, explains, “We’ve seen, as you said, this trend has been increasing, the incidence of colorectal cancer in individuals under 50 for some time. But we really didn’t know why or how it differed between younger and older patients. That’s what our study aimed to address.”

The team analyzed 189 tumors and examined over 850,000 individual cell nuclei, utilizing samples from more than 50 patients under the age of 50. Anderson points out that they found significant differences in the cells and gene expression in tumors from younger patients compared to their older counterparts.

“Specifically, we found that stromal cells, which are responsible for making connective tissue, were present in higher proportions relative to the malignant cancer cells in younger patient tumors,” Anderson noted. These stromal cells might produce factors that suppress the immune system, complicating the body’s ability to combat cancer, and could also create barriers that hinder drug penetration into tumors.

Additionally, researchers discovered genetic differences that may lead to more aggressive forms of the disease. While the study doesn’t fully explain why younger individuals are facing higher colorectal cancer rates, Anderson believes it opens avenues for further exploration, which may eventually result in treatments aiming specifically at younger patients.

“Before, we were simply trying to identify differences, but now we have specific differences to investigate further, which could help us understand the biology and lead to interventions down the line,” she said.

For Vincent, the research findings and the possibilities they present are heartening. “It’s exciting to me because the last thing I want is for another young person with a young family to have to go through what I went through,” she expressed.

She encourages others, especially younger adults, to pay attention to warning signs. “If you are seeing blood in your stool, you really need to contact your doctor immediately if it happens repeatedly, because the sooner you can get diagnosed, the higher your chances of beating this,” Vincent advised. “So please don’t feel embarrassed. Colonoscopies aren’t that bad. It’s crucial to catch things early.”