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Blood test shows potential as way to screen for early-onset colorectal cancer

With rising rates of colorectal cancer in adults under 50, this research is a first step to noninvasively and inexpensively detect colorectal cancer at an earlier and more treatable stage

Scientists at City of Hope have developed a novel blood test that may in the future be used to detect early-onset colorectal cancer, which has been on the rise in younger adults in recent years.

Doctor Ajay Goel
Ajay Goel, Ph.D.

“More research is needed, but this finding could help fill a void in the cancer prevention and early detection field, which does not currently have a noninvasive and accurate way to detect the presence of nonhereditary colorectal cancer in people younger than 50 years old,” said Ajay Goel, Ph.D., professor and chair of the Department of Molecular Diagnostics and Experimental Therapeutics at City of Hope. “The study is significant because it is the first time a novel microRNA (miRNA) biomarker has been identified, developed and validated to detect early-onset colorectal cancer.”

Colorectal cancer is the fourth most common cancer, according to the U.S. Centers for Disease Control and Prevention. The rate of colon or rectal cancers in people younger than 50 years old has been on the rise, an alarming trend, particularly because young people diagnosed with this nonhereditary form of colorectal cancer generally have more aggressive and advanced disease at diagnosis compared to late-onset colorectal cancer diagnosed in people 50 years or older. As a result, the recommendation to begin regular colorectal cancer screening has been moved to start five years earlier at age 45.

In the study, recently published in the journal Gastroenterology, researchers systematically conducted a genome-wide analysis to identify miRNA signatures by analyzing a large, publicly available dataset. They extrapolated the data of patients with either Stage 1 or 2 early-onset colorectal cancer (42) or patients with late-onset colorectal cancer (370). (MiRNAs regulate gene expression.) Scientists then validated the results using blood samples from 149 patients with early-onset colorectal cancer and compared the data with a control group of 110. 

To enhance specificity and accuracy, the researchers eliminated all miRNA markers shared by people with early- and late-onset colorectal cancer to better identify patients with early-onset colorectal cancer. They were able to identify four miRNAs that, combined, create a signature biomarker which can be used to detect and diagnose the presence of early-onset colorectal cancer in younger adults.

While exciting, more research using larger patient cohorts must be performed before this novel liquid biopsy can be used in the clinic.

“The goal would be to eventually be able to use this test as a part of an annual physical exam or every six months for people who are at high-risk for colorectal cancer due to the genes they inherited,” Goel said. “Noninvasive fecal and blood tests that are currently available to people are not yet able to accurately detect early-onset colorectal cancer.”