When the world was impacted by the unexpected loss of Chadwick Boseman to colon cancer in 2020, at the young age of 43, his death shed a spotlight on the rise of colon cancer in younger people, meaning those under 45 and some as young as their 20s. Over the past few years, this cancer has even affected people with a history of generally good health.
According to the Cancer Research Institute, colon cancer is the third most diagnosed cancer and the third leading cause of cancer death in both men and women in the United States. When it comes to the African American community, the impact is more devastating. The American Cancer Society found that Black people in the United States are 20% more likely to get colon cancer and 40% more likely to die from it compared to other races.
“This disease is ravaging the Black community, and it is as important as ever that everyone has access to and is receiving the recommended screenings,” said Durado Brooks, M.D., vice president of prevention and early detection at the American Cancer Society, in a statement posted by the organization a few years ago.
There are a lot of issues at play for African Americans, and some of it is due to racial and economic disparities in healthcare, family history, and personal history. Ultimately, there aren’t definitive answers as to why there’s a rise in cases, especially aggressive forms, in young adults, but leading theories pinpoint the modern diet, which includes too many ultra-processed foods, not enough fiber, too much sugar, and lifestyle choices like staring into the blue light of our phones too much, which can disrupt our natural rhythms. Even exposure to microplastics is a theory. However, there’s some promising emerging research that can provide insight that traces back to the first year of life.
Some of this research suggests that the first months and years of life could be an important window for intervention. At UC San Diego, molecular biologist Ludmil Alexandrov recently identified a mutational signature in more than half of colorectal tumors in patients under 40 that appears to be caused by colibactin, a toxin produced by a strain of E. coli.
What surprised researchers was how early they detected potential damage. Researchers usually find DNA damage building up in the adult body. Grilling meats, smoking, and certain occupations that expose people to cancer triggers like asbestos are typically ignited when our DNA gets more unstable with age. But in Alexandrov’s study, the infection occurred before babies reached their ninth month of life. This research is preliminary, but the DNA mutation findings suggest that some infants might be predisposed to developing colon cancer within a few decades.
“You get your first hit at age 1 instead of age 30,” Alexandrov said. “So you are about 20 to 30 years ahead of schedule for cancer.”
When you’re 35, you don’t consider what may have happened in your body at 6-months-old that could have influenced your health as an adult, which means there’s a disconnect in how prevention and treatment are viewed. Alexandrov’s findings still need to be confirmed in bigger studies, but if so, they could provide answers to early-onset colon cancer. The rise in youth could be rooted in early life, with adulthood being the time at which the incubation period reaches its boiling point.
If colibactin infections are an early trigger, the most effective preventive strategy would be to prevent mutational DNA damage. That would involve targeted microbial restoration and diet strategies designed for an infant’s developing immune system. Alexandrov envisions probiotics for infants designed to neutralize colibactin-producing bacteria. These findings underscore the theory that the microbiome plays a role in this disease, which is also connected to diet. Scientists emphasize that diet isn’t the only answer, as there may be a variety of factors at play, but these new findings are promising, with ongoing studies.