Abdominal pain, diarrhea, rectal bleeding, iron deficiency anemia. These are four critical indicators and symptoms that indicate a greater likelihood of developing early-onset colorectal cancer. These were discovered by a research team from the Washington University School of Medicine in St. Louis, in the United States, according to which certain warning signs can play a decisive role in identifying and diagnosing this type of tumor more quickly in young adults. Published on Journal of the National Cancer Instituteresearch warns people under 50 about the dangers associated with colorectal cancer, the incidence of which has nearly doubled in recent times.
Analyzing anonymous health insurance data from more than 5,000 patients with early-onset colorectal cancer (Eo-CCR) – a cancer that develops before age 50 – researchers found that within 90 days or 24 months before diagnosis, experiencing abdominal pain, diarrhea, rectal bleeding, and iron deficiency anemia increases the risk. And while rates of early-onset colorectal cancer have increased in recent years, research into the causes has not kept pace.
Although timely diagnosis is crucial, universal population screening with traditional methods may be cost-ineffective to address the (increasing) incidence of Eo-CRC. This is why it is essential to better understand the pathogenesis (which investigates the development of a disease and the chain of events related to it) of early-onset colorectal cancer and to identify diagnostic biomarkers – defined by the Italian Medicines Agency (AIFA) as “characteristics that distinguish an individual based on the presence or absence of a specific physiological, physiopathological state or disease” – for risk-based screening.
Advances in Multi-omics Technologies
To tackle colorectal cancer (which affects the last part of the digestive and gastrointestinal system), surgeons are increasingly relying on digital. In particular, we are talking about AI applied to colorectal surgery before, during and after operations. Without forgetting that recent discoveries in the field of the microbiome (the totality of genes that the microorganism expresses) and the metabolome (the set of substances that participate in the processes of an organism) offer new opportunities.
Thus, using advanced machine learning techniques in the context of multiomic analysis – an approach in which family history, personal history and test results identify a specific patient profile – researchers at the Cleveland Clinic, a US university medical center, studied the effectiveness of classifiers based on microbiome and metabolome characteristics to differentiate early-onset colorectal cancer from late-onset colorectal cancer.
Published in Nature, the study shows that multiomics analysis can identify unique host-microbiome interactions associated with early-onset colorectal cancer, providing biomarkers for screening and treatment. In practice, modulating the microbiome through dietary interventions and probiotics (bacterial strains “good” capable of resisting the action of gastric juice and bile secretion and of settling in the intestine by adhering to epithelial cells, thus fighting the adhesion of some pathogenic germs) could therefore prove to be an effective prevention and treatment strategy.
Anti-cancer lifestyles
If early diagnosis allows us to anticipate the moment in which a tumor is discovered, other simple interventions reduce the risk of some neoplasms. We are talking about healthy habits and behaviors that, if followed by everyone, could prevent the appearance of about one cancer in three. In particular, as Professor Umberto Veronesi has always stated, the table represents the first place in which to carry out prevention. According to an epidemiological research published in the journal JNCI Cancer Spectrum In 2019, more than 5 percent of colorectal cancers diagnosed in the United States four years earlier could be attributed to an inadequate diet.
“Diet is precisely a lever on which to act to prevent the onset of this pathology”, explains Elena Dogliotti, nutrition biologist and member of the scientific supervision of Fondazione Veronesi. The one most associated with a preventive diet is the Mediterranean diet; a diet that is increasingly popular among Italians, whose habits mainly consist of opting for certain foods (whole grains, fresh fruit and vegetables, legumes, extra virgin olive oil, dried fruit and seeds, fish) and limiting others (sweets, alcoholic beverages, processed meats, red meats).