Why are healthy young adults getting colon cancer? Researchers may finally have a lead

One of the biggest mysteries cancer researchers are trying to solve is why colorectal cancer rates are soaring among young adults. 

Now the leading cause of cancer-related deaths among men and women under the age of 50, colorectal cancer has become an alarming outlier among a general decrease in cancer mortality in recent decades. But a paper published last month in Nature Medicine that examined the risk of early-onset cancer has provided a new clue, triggering a lively discourse in the science community—and beyond.

A team of researchers at Washington University School of Medicine in St. Louis set out to examine whether faster biological aging could be a factor that’s associated with an increased risk of several early-onset cancers, including colorectal cancer. The researchers found that younger generations of people in the U.S. and the United Kingdom appear to be aging faster biologically, as a result of a broad range of physical, social, and sociopolitical factors. 

“Our findings suggest that accelerated biological aging is associated with a higher risk of developing multiple cancers earlier in life, specifically early-onset lung cancer, colorectal cancer and uterine cancer,” molecular epidemiologist Yin Cao, who led the work, said in a summary of the paper’s significance. 

Cao is also one of two scientists leading PROSPECT, a team within the broader $25 million global Cancer Grand Challenges that was founded in 2024 and tasked with investigating the rise of colorectal cancers in younger adults. 

Led by Cao, the researchers examined nine different blood biomarkers among people born after 1965 versus those born between 1950 and 1954, finding a higher likelihood of accelerated aging among the younger cohort. That could be key to understanding early-onset cancer as the median age of diagnosis is 67 years old, according to figures from the National Cancer Institute.

SLOW DOWN AGING, SLOW DOWN CANCER?

Though the paper’s findings must be validated, the team may have discovered a minimally invasive method for early cancer detection, along with risk-based targeted screening and even prevention measures.

“There will be more work on validation—leveraging existing and under-utilised clinical data—as well as mechanistic understanding, and how we potentially even slow down biological aging in younger populations,” Cao said. 

Even so, the buzz about the findings is notable. In the two weeks since the paper was published, 56,000 people have already accessed it and it’s the top-ranked among 132 articles of a comparable age published in the publication.

UNDERSTANDING CANCER CAUSAL RISK FACTORS

PROSPECT has brought together researchers across nine institutions in France, India, Italy, the U.K., and the U.S. The goal is to “unravel the intricate network of causal factors” that underlie the increase in early-onset cancer and reverse the trend, Andrew Chan, a physician-scientist at Massachusetts General Hospital who is leading the project with Cao, said in a video posted on the project’s website. 

“We are in desperate need to really identify the causal risk factors for early onset colorectal cancer and try to identify the strategies to reverse that trend,” Cao said in the same video. 

Various teams within Cancer Grand Challenges are advancing research into things like the causes of cancer, disparities in cancer among different demographics, and why some types of cancer are lethal or not. 

“Cancer Grand Challenges is enabling us to ask fundamentally new questions about the origins of early-onset cancers and accelerate the discovery of risk factors by connecting population-level evidence with biological mechanisms,” Cao said in the summary about the recent research paper.

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