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It’s the phenomenon that’s baffled doctors around the world: bowel cancer, usually a disease of the elderly, has soared by 50 per cent in 20, 30 and 40-somethings over the past 30 years.
Now, in a fascinating discussion between two of the world’s leading cancer experts, a new theory as to the explanation behind the trend has been tabled.
While acknowledging that there is likely ‘several’ contributing factors, the top specialists have suggested that a common childhood infection could be partly to blame for rising young cases of the disease, known as colon cancer in the US.
In an interview with The Health Foundation, Dr Charles Swanton, Chief Clinician of Cancer Research UK, spoke of ’emerging data’ showing that a specific type of the bacteria E. coli contracted in childhood could ‘contribute at least to some of the cancer initiation processes.’
Alarming evidence of this is offered by fellow cancer specialist, Dr Kimmie Ng, US specialist in young-onset colorectal cancer, who noted that many of her young cases are in fact in children.
Bowel cancer can cause you to have blood in your poo, a change in bowel habit, a lump inside your bowel which can cause an obstructions. Some people also suffer with weight loss as a result of these symptoms
Top cancer doctors Kimmie Ng (left), specialist in oncology and Director of the Young-Onset Colorectal Cancer Centre at the Dana Farber Cancer Institute in Boston, and Charles Swanton (right), Chief Clinician at Cancer Research UK, discuss what’s behind this worrying rise
Dr Kimmie Ng, Director of the Young Onset Colorectal Cancer Centre at the Dana Farber Cancer Institute in the US, said: ‘Although there isn’t published data necessarily on the rate of increase and whether it’s affecting the paediatric population, at least anecdotally I have certainly been seeing some children with colorectal cancer.’
She added that the E. coli findings are ‘really provocative and very interesting,’ and that the infection is likely to be a ‘very early event’ in someone’s life.
‘This is consistent with our hypotheses that whatever exposure or inciting factor is happening is probably happening in the early life course.’
She added that thyroid cancer has also been increasing as well as kidney cancer, which is also on the rise in young people.
Data from JAMA Surgery showed colon cancer is expected to rise by 90 percent in people ages 20 to 34
The type of E. coli the experts pinpointed is a specific strain known as PKS-positive E. coli.
It is not linked to food poisoning outbreaks, but is thought to develop via interactions with the trillions of microbes in our gut.
Scientists aren’t entirely sure how PKS-positive E. coli develops, but one 2022 study found an association between the presence of the bacteria in colorectal cancers and western-style diets.
A 2020 study published in the journal Nature suggested a person’s chance of developing bowel cancer may increase after becoming infected with this specific type of E.coli.
Scientists believe the bacterium — which is thought to be present in up to one in five people, according to a 2023 study published in the journal Life Sciences — releases a toxin which can damage the cells that line the bowel. The study says this can potentially turn some cells cancerous over time.
Although our junk-food laden diets, smoking and obesity are often blamed for the rise in cancer, experts say these subtle gut bacteria changes are much more likely to be a major contributing factor.
Dr Ng claims that in her experience many of her patients are young and not obese.
In fact, many young people diagnosed with bowel cancer lead healthy and active lifestyles, suggesting it’s not just obesity behind this rise in cases.
‘Many are triathletes and marathon runners, and so it is really puzzling why this is happening,’ she said.
‘I mean, the hypothesis put out there is that the reason why the incidence is rising among all digestive system cancers is this common theme of obesity being a risk factor.
‘But I have not seen that myself in the patients whom I’ve taken care of.’
Dr Swanton added that although many scientific studies say obesity is a big risk factor in early onset colorectal cancer, he suggests this is not always the case.
He said: ‘My impression at least clinically is that that doesn’t always bear fruit, that argument, and that many of these early onset cancers are associated with individuals who aren’t obese or overweight.’
MailOnline has repeatedly documented the global rise of colon cancer among young people.
Perhaps the most recognisable victim of the trend is Deborah James — known as ‘bowel babe’ — who was diagnosed at just 35 and raised millions for charity in her final days in 2022.
Analysis suggests deaths from bowel cancer overall in the UK are set to rise by 2,500 a year between now and 2040.
Meanwhile, the number of people in the UK diagnosed with the disease will rise by around a tenth in the same period.
Bowel cancer currently kills just shy of 17,000 Brits each year with only half of those diagnosed expected to survive 10 years after learning they have the disease.
COLON CANCER: WHAT ARE THE WARNING SIGNS?
Bowel, or colorectal, cancer affects the large bowel, which is made up of the colon and rectum.
Such tumors usually develop from pre-cancerous growths, called polyps.
Symptoms include:
- Bleeding from the bottom
- Blood in stools
- A change in bowel habits lasting at least three weeks
- Unexplained weight loss
- Extreme, unexplained tiredness
- Abdominal pain
Most cases have no clear cause, however, people are more at risk if they:
- Are over 50
- Have a family history of the condition
- Have a personal history of polyps in their bowel
- Suffer from inflammatory bowel disease, such as Crohn’s disease
- Lead an unhealthy lifestyle
Treatment usually involves surgery, and chemo- and radiotherapy.
More than nine out of ten people with stage 1 bowel cancer survive five years or more after their diagnosis.
Unfortunately, only around a third of all colorectal cancers are diagnosed at this early stage.
The majority of people come to the doctor when the disease has spread beyond the wall of the colon or rectum or to distant parts of the body, which decreases the chance of being successfully cured of colon cancer.
According to Bowel Cancer UK figures, more than 41,200 people are diagnosed with bowel cancer every year in the UK.
It affects around 40 per 100,000 adults per year in the US, according to the National Cancer Institute.