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   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Researchers chart a course for understanding, preventing, and treating   
   young-onset colorectal cancer    
      
     Date:   
         March 16, 2023   
     Source:   
         Dana-Farber Cancer Institute   
     Summary:   
         Researchers outline the complexities of young-onset colorectal   
         cancer and the research needed to map out a path toward   
         understanding it.   
      
      
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   FULL STORY   
   ==========================================================================   
   Colorectal cancer among young people is increasing globally and rapidly.   
      
   Experts expect it to become the leading cause of cancer death in   
   individuals aged 20-49 in the U.S. by the year 2030.   
      
      
   ==========================================================================   
   Yet no one is certain why this disease is suddenly affecting so many   
   young people. In a new paper published in Science, Dana-Farber Cancer   
   Institute researchers outline the complexities of the disease and the   
   research needed to map out a path toward understanding it.   
      
   "The rising incidence of young-onset colorectal cancer is extremely   
   concerning, and it is urgent that the scientific community comes   
   together to better understand the underlying causes and biology,"   
   said co-author Kimmie Ng, MD, MPH, associate chief of gastrointestinal   
   oncology and director of the Young- Onset Colorectal Cancer Center at   
   Dana-Farber. The Center provides expert care for patients and conducts   
   the multidisciplinary research required to understand colorectal cancer   
   in young adults and develop new ways to prevent, detect and treat it.   
      
   Young-onset Colorectal Cancer: a unique challenge Young-onset colorectal   
   cancer (CRC), also called early-onset CRC, differs from later-onset CRC   
   in several ways, according to the authors. Young-onset disease is often   
   more aggressive, presents on the left side of the colon rather than the   
   right, and often presents with rectal bleeding and abdominal pain.   
      
   At a molecular level, however, studies have shown conflicting results   
   that suggest both similarities and differences in the genetic mutations   
   that drive the diseases. This is likely due to the complexity of the   
   disease, according to the authors, and future research should account   
   for this variability.   
      
   More study is also needed to determine if CRC risk factors for young   
   people are similar to those for older adults. Obesity and environmental   
   exposures, for instance, have been associated with young-onset disease,   
   but other factors could also play a role, such as increased antibiotic   
   use or the frequency of Cesarean sections, both of which could influence   
   the microbiome. To begin to understand the risk factors, the authors   
   suggest that investigations should include a combination of genetics,   
   environmental exposures, diet and lifestyle measures, as well as immune   
   system interactions and the microbiome composition.   
      
   One clear difference is that young-onset CRC is typically discovered   
   after the disease has advanced. This is due in part to the fact that   
   screening for colorectal cancer starts at age 45 in the U.S., so the   
   disease often goes undetected in younger people.   
      
   "It's important not to dismiss the idea that a young person could have   
   colorectal cancer even though the disease is still more common in older   
   adults," said co-author Marios Giannakis, MD, PhD, a gastrointestinal   
   oncologist at Dana-Farber.   
      
   Responding with multidisciplinary research involving diverse populations   
   To account for the complexity of young-onset CRC, Ng and Giannakis said   
   that research should be multidisciplinary and include many areas of   
   investigation simultaneously. For instance, genome-wide association   
   studies, which aim to find risk genes for the disease, should also   
   include data about environmental exposures that could also increase risk.   
      
   These types of studies could point to new ways to identify young people   
   who are at high risk of young-onset disease and should be screened for   
   CRC. "Risk stratification is going to be very important as we think   
   about screening for young-onset disease," said Giannakis.   
      
   Clinical studies should also include the collection of blood, tissue,   
   and stool samples from patients over time to shed light on the role of   
   immune cells, environmental exposures and the microbiome in disease onset,   
   progression, and treatment response. Ng and Giannakis encourage global   
   collaborations aimed at facilitating the collection of these specimens,   
   such as the Count Me In Colorectal Cancer Project, which directly partners   
   with patients in the U.S.   
      
   and Canada and makes all data available for research.   
      
   Ng and Giannakis also call for more effort in ensuring diverse   
   populations are included in studies of young-onset CRC. Studies show   
   underrepresented minorities are disproportionally burdened by young-onset   
   CRC and non-Hispanic Black patients have a higher mortality rate when   
   compared to non-Hispanic whites.   
      
   "Although each of these steps require commitment and perseverance,"   
   said the authors, "it is the growing numbers of young patients bravely   
   battling this disease that will be the compass that keeps us on the   
   path towards better understanding, preventing, and treating young-onset   
   colorectal cancer."   
       * RELATED_TOPICS   
             o Health_&_Medicine   
                   # Colon_Cancer # Diseases_and_Conditions # Breast_Cancer   
                   # Cancer # Lymphoma # Chronic_Illness # Prostate_Cancer   
                   # Lung_Cancer   
       * RELATED_TERMS   
             o Colorectal_cancer o Stem_cell_treatments o   
             Positron_emission_tomography o Cervical_cancer o Breast_cancer   
             o Prostate_cancer o Ovarian_cancer o Adult_stem_cell   
      
   ==========================================================================   
   Story Source: Materials provided by Dana-Farber_Cancer_Institute. Note:   
   Content may be edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Marios Giannakis, Kimmie Ng. A common cancer at an uncommon   
      age. Science,   
         2023; 379 (6637): 1088 DOI: 10.1126/science.ade7114   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2023/03/230316140939.htm   
      
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