A new study shows that long-term inflammation in the colon may physically change the tissue in a way that encourages early-onset colorectal cancer (CRC).
Scientists discovered that this ongoing inflammation can make the colon tissue stiffer, which might help cancer start and grow faster.
These findings, published in the journal Advanced Science, may help doctors find better ways to detect and treat this serious form of cancer, especially in younger people.
The research was done by scientists at UT Southwestern Medical Center and The University of Texas at Dallas. One of the lead researchers, Dr. Emina Huang, said this is an important step forward in understanding why younger people are getting CRC more often and how we might treat it better in the future.
Dr. Huang is a surgeon and professor who studies colon cancer and works in both surgery and biomedical engineering.
For many years, colorectal cancer was mainly seen in people over 50. These cases, called average-onset or sporadic CRC, have been decreasing in both diagnosis and death rates over the last 30 years.
But in recent years, more people under 50 are being diagnosed with CRC. These are called early-onset cases, and they now make up about 12% of all colorectal cancer cases in the U.S. The reasons for this increase have not been clear.
While researchers have looked at possible causes like poor diet, obesity, and other environmental factors, they had not fully understood how these might lead to cancer. This new study gives a clearer picture by showing that long-term inflammation might cause lasting damage to colon tissue.
Dr. Huang and her team believe that inflammation over time leads to scarring, which makes the tissue stiffer. Similar changes in tissue stiffness are known to lead to cancer in other organs, like the breast and pancreas. The team wondered if this could also be true for the colon.
To find out, they studied colon tissue from people who had surgery to remove tumors. They looked at 19 samples from people with average-onset CRC and 14 from younger patients with early-onset CRC. Each sample had both tumor tissue and nearby healthy tissue.
They found that the tissue from younger patients with early-onset CRC was stiffer than the tissue from older patients, both inside the tumors and in nearby areas that weren’t cancerous. This suggests that the stiffness may have been present even before the cancer formed.
The team then looked closely at collagen, a protein that gives structure to tissue and increases during scarring.
They found that in early-onset CRC, collagen was more dense, more mature, and more organized, showing signs of heavy scarring. They also found that genes linked to collagen, blood vessel growth, and inflammation were more active in the early-onset group.
Stiffness doesn’t just change how tissue feels—it also affects how cells behave. The researchers found that in stiffer environments, cancer cells grew faster and became more rigid.
This was confirmed in lab experiments using cancer cells grown on stiff surfaces and in 3D organoid models, where cells were placed in artificial environments. In both cases, stiffer surroundings led to faster and larger growth.
These discoveries suggest that a stiff colon environment may make it easier for cancer to start and spread in younger people.
Dr. Huang believes that targeting the biological pathways that respond to physical stiffness—called mechanotransduction—might help slow or stop the growth of cancer. This approach is already being studied for other types of cancer.
Another important point is that measuring how stiff the colon tissue is might become a new way to detect people at risk for early-onset CRC, just like colonoscopies are used to find early signs of cancer in older adults.
Dr. Huang, who holds a special research chair and is part of a major cancer research program in Texas, says these results open up new paths for diagnosis and treatment that could benefit many patients in the future.
If you care about cancer, please read studies that artificial sweeteners are linked to higher cancer risk, and how drinking milk affects risks of heart disease and cancer.
For more health information, please see recent studies about the best time to take vitamins to prevent heart disease, and results showing vitamin D supplements strongly reduces cancer death.
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