SCIENTISTS believe they have pinpointed the main risk factor for bowel cancer in young people.
They found evidence that diet is the key driver of the disease in those under the age of 60.
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They looked at molecules called metabolites which are produced in response to the foods we eat.
Their report highlighted that the best way anyone under the age of 60 can prevent bowel cancer is to discuss their diet with their doctor.
Dr Suneel Kamath, senior author and gastrointestinal oncologist at Cleveland Clinic, said: “At the end of the day, it’s impractical to apply our care models for those over 60 to younger adults simply because we cannot give everyone in the system yearly colonoscopies.
“What is much more feasible is to give everyone in the system a simple test to measure a biomarker that determines their bowel cancer risk.
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“Then we can give the most at-risk individuals appropriate screening.”
Red and processed meat appears to be most damaging for bowel cancer risk, the study showed.
The team had previously looked at differences in the metabolites (diet-derived molecules) of young- versus average-onset bowel cancer, as well as differences in the gut microbiomes of younger and older adults with the disease.
But they wanted to study this in more detail.
Researchers looked at data from men and women who received care for either young- or average-onset bowel cancer.
They developed an artificial intelligence (AI) algorithm to combine and analyse existing studies’ datasets and clarify what factors were most relevant for future study.
This revealed that differences in diet accounted for a significant proportion of the differences observed between the young-onset and older-onset patients.
Dr Naseer Sangwan, director of the Microbial Sequencing & Analytics Resource Core, said: “Researchers – ourselves included – have begun to focus on the gut microbiome as a primary contributor to bowel cancer risk.
“But our data clearly shows that the main driver is diet.
“We already know the main metabolites associated with young-onset risk, so we can now move our research forward in the correct direction.”
The team said they were “excited” to see diet play such a large role in cancer risk because it is much easier to identify at-risk patients by counting the metabolites in their blood than it is to sequence the bacterial DNA in their stool for different microbes.
“It can actually be very complicated and difficult to change your microbiome,” Dr Kamath said.
“While it’s not always easy, it is much simpler to change your diet to prevent bowel cancer.”
Known bowel cancer risk factors
SCIENTISTS don’t know what causes most bowel cancers, but they do understand that some factors increase your risk of getting the disease.
Some, like age and genetics, you can’t do anything about, but making some simple lifestyle changes could make a big difference.
According Bowel Cancer UK, you are more at risk of bowel cancer if you have one or more of the following:
- Aged over 50
- A strong family history of bowel cancer
- A history of non-cancerous growths (polyps) in your bowel
- Longstanding inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis
- Type 2 diabetes
- An unhealthy lifestyle
Experts believe more than half of all cases could be prevented by:
- Avoiding processed meat and limiting red meat intake
- Eating plenty of fibre from wholegrains, pulses, vegetables and fruit
- Maintaining a healthy body weight
- Staying hydrated (drinking about 1.6 to two litres of fluid a day)
- Being more active (e.g. taking the stairs instead of a lift, walking to the shops, doing housework, walking the dog, dancing, swimming, hiking)
- Lowering your alcohol intake
- Quitting smoking
Risk foods
The results, published in npj Precision Oncology, showed that younger patients had higher levels of metabolites associated with the production and metabolism of an amino acid called arginine, and with the urea cycle compared to their older peers.
These differences may be tied to long-term consumption of red meat and processed meat, the authors said.
They are now analysing national datasets to see if they find the same across the United States.
If they show that arginine and urea cycle metabolites – and, by proxy, red and processed meat overconsumption – are elevated across younger adults with bowel cancer nationwide, they plan to test whether certain diets and commercially-available drugs can regulate these levels.
They hope this in turn could help prevent or even treat young-onset bowel cancer.
I always make sure to bring diet up to my patients to try and equip them with the tools they need to make informed choices about their lifestyle
Dr Suneel Kamath
Dr Kamath said that even though more research is needed to understand exactly how dietary factors cause bowel cancer, his current findings have already changed the way he delivers patient care.
“Even though I knew before this study that diet is an important factor in bowel cancer risk, I didn’t always discuss it with my patients during their first visit,” he added.
“There is so much going on, it can already be so overwhelming.
“Now, I always make sure to bring it up to my patients, and to any healthy friends or family members they may come in with, to try and equip them with the tools they need to make informed choices about their lifestyle.”
Bowel cancer is the fourth most common form of the disease in England.
Public awareness is on the up thanks to campaigners like Sun writer Dame Deborah James, who died from the disease in 2022 at just 40 years old.
What are the red flag warning signs of bowel cancer?
IT’S the fourth most common cancer in the UK, the second deadliest – yet bowel cancer can be cured, if you catch it early enough.
While screening is one way of ensuring early diagnosis, there are things everyone can do to reduce their risk of the deadly disease.
Being aware of the signs and symptoms of bowel cancer, spotting any changes and checking with your GP can prove a life-saver.
If you notice any of the signs, don’t be embarrassed and don’t ignore them. Doctors are used to seeing lots of patients with bowel problems.
The five red-flag symptoms of bowel cancer include:
- Bleeding from the back passage, or blood in your poo
- A change in your normal toilet habits – going more frequently for example
- Pain or a lump in your tummy
- Extreme tiredness
- Losing weight
Tumours in the bowel typically bleed, which can cause a shortage of red blood cells, known as anaemia. It can cause tiredness and sometimes breathlessness.
In some cases bowel cancer can block the bowel, this is known as a bowel obstruction.
Other signs include:
- Gripping pains in the abdomen
- Feeling bloated
- Constipation and being unable to pass wind
- Being sick
- Feeling like you need to strain – like doing a number two – but after you’ve been to the loo
While these are all signs to watch out for, experts warn the most serious is noticing blood in your stools.
But, they warn it can prove tricky for doctors to diagnose the disease, because in most cases these symptoms will be a sign of a less serious disease.
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