New Insights into Young-Onset Colon Cancer

“It’s been a bit of a black box,” remarked Ana Anderson, a key researcher at the Gene Lay Institute of Immunology and Inflammation at Brigham and Women’s Hospital. “Now, we have a research direction. We hope to uncover something specific to this disease that could pave the way for tailored therapies aimed at young-onset colon cancer.”

In the U.S., the American Cancer Society reports that rates of colorectal cancer among those under 50 have risen nearly 3 percent annually from 2013 to 2022. It’s alarming, really; colorectal cancer has become the leading cause of cancer deaths in this age group.

Researchers have been trying to make sense of this troubling trend. Evidence is accumulating that suggests diet and ultra-processed foods might play a role, along with other lifestyle and environmental elements. Yet, experts also emphasize the need to delve deeper into what’s happening within the tumors of younger patients.

A recent study, published in the peer-reviewed journal Nature Medicine, investigated 189 tumors from individuals aged 20 to 90, including 54 diagnosed before turning 50. They examined over 850,000 cells and identified changes that correlated with age, pointing out distinct variations between younger and older patients, according to Dr. Kimmie Ng, a senior author and director of the Young-Onset Colorectal Cancer Center at Dana-Farber Cancer Institute.

The findings indicated that tumors in younger patients contained a different blend of cells, especially a greater number of connective and supporting cells—known as stromal cells. Previous studies in other cancer types have linked these stromal cells to resistance against chemotherapy.

Moreover, the research revealed differences in gene expression within the tumors of younger individuals, a discovery that may open doors to new treatment targets.

This dataset stands out as the largest collection of colorectal cancer data to date, notably featuring a significant number of young patients, according to Ng.

“It gives a huge amount of hope,” she expressed. “This really serves as a guidepost for where we should channel our future research efforts.”

Dr. John Paul Shen, an associate professor at the University of Texas MD Anderson Cancer Center, highlighted that this new research grants scientists extensive, detailed data. “There are some clear experiments we might conduct in our labs or that others could do worldwide,” he noted, although he wasn’t part of the study. “That’s immensely valuable.”

Yet, he and other experts caution that while the dataset is expansive in cellular analysis, it is somewhat limited in terms of diverse participants. Ng reassured that the cohort reflects the broader profile of young-onset colorectal cancer patients globally.

Looking ahead, Dr. Christina Annunziata, senior vice president at the American Cancer Society, suggested that future studies could involve analyzing different patient groups.

Despite the promise this research holds for advancing preventive and therapeutic strategies for colorectal cancer in young people, experts believe significant breakthroughs may still require time. Annunziata pointed out that possessing this dataset is “an essential first step.”

“We need this research to grasp why more people are developing cancers at an early age and what interventions we can implement,” she added.