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Antibiotics: Curing Your Infections, But May Lead to Cancer

In the late 1800s/early 1900s, there was a desperate need for researchers to develop medications that could kill bacteria. Pneumonia and diarrhea (conditions that seem quite easy to treat today) were killing people left and right. After years of experiments and studies, manufacturers began mass-producing an antibiotic called penicillin in 1944, a medication that they called the “wonder drug”. 

Antibiotics can clear a vast assortment of bacterial infections, ease symptoms, speed up the recovery process, prevent the spread of ailments from one individual to another, etc. It really is no surprise that physicians were thrilled about this medication and began widely prescribing it even if it wasn’t entirely necessary.

Dangers of the “Wonder Drug”

Despite all of the incredibly healing properties of antibiotics, there is also a lot of damage that they can do as well. For instance, in our bodies, the microbiome in the gut is vital to the food digestion process, breaking down toxic chemicals in the body, and assisting with the regulation of the immune system. When a person consumes antibiotics, however, the gut microbiome can be heavily disrupted, which leads to the over- or underproduction of certain chemicals that are an integral part of the immune system. This imbalance can be quite dangerous, and can actually lead to the development of various cancers. 

Study Linking Antibiotic Use to CRC

In 2022, researchers wanted to see if there was a specific link to antibiotic usage (particularly among younger individuals) and the development of colorectal cancer (CRC). Using census data between the years 2000 to 2011, scientists analyzed 7,903 Scottish individuals who had an official CRC diagnosis, and split them into two comparative groups: 

  • 445 early onset individuals (those who had received a diagnosis at under 50 years) 
  • 7,458 regular onset individuals (those who had received a diagnosis at over 50 years)

While comparing both groups, researchers separately analyzed antibiotic usage to see if there was a positive relationship between increased antibiotic usage and CRC development. 

And what did they find?

Antibiotic usage was associated with an estimated 49% higher risk of CRC in the early onset group compared to a 9% higher risk in the regular onset group. However, a statistically-significant link was not confirmed between the two variables, meaning that a causal relationship cannot be established between antibiotic use and development of CRC. 

Though researchers cannot explicitly define antibiotics as being contributors to CRC or other cancers, there is a link between the two. In terms of moving forward, more research must be conducted on this specific relationship, though researchers and physicians recommend the usual: healthy lifestyle choices to prevent CRC, regardless of antibiotic usage. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Your Breath May be Whispering Your Risk of Colorectal Cancer

Breathe out into an airtight bag and take a whiff. How unpleasant is the odor? Now, consider this: what if the intensity of your breath’s scent could indicate your likelihood of developing colorectal cancer (CRC)? 

Bad breath, or halitosis, is a fairly common problem. The root cause of bad breath could be poor oral hygiene, certain foods, smoking, or underlying health conditions such as gum disease or dry mouth. It could also be an indicator of diseases such as diabetes. A study conducted in South Korea has discovered a potential connection between oral health and colorectal adenoma. Colorectal adenoma is a non-malignant growth that develops on the inner lining of the colon or rectum and is a significant risk factor for CRC. This finding is supported by other studies that have established a correlation between oral health and gastrointestinal disorders.

How Was the Study Done?

The cross-sectional study involved 42,871 eligible patients. The median age of the participants was 39 years, with a majority (70.4%) being men. In the sample population, adenoma was found in 12% of cases. Factors associated with a higher risk of adenoma included:

  • BMI of 25.0 kg/m2 or more 
  • Periodontitis (gum disease)
  • Moderate alcohol intake 
  • Heavy alcohol intake 
  • Tooth loss

Being male or a former or current smoker, having an alcohol intake above a moderate level, and experiencing periodontitis and tooth loss all increase the risk of colorectal adenoma. Any form of gum disease is a leading cause of bad breath.

Your breath has a lot to say about your health. By paying attention to the quality of your breath and any changes you notice, you can potentially catch early signs of certain health conditions. It is important to listen to what your breath is telling you. Now, take another deep breath and exhale into an airtight bag. Take a sniff and decide whether you should schedule an appointment with your dentist or your gastroenterologist.

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Picture credit: Bruno from Pixabay.

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Colon Cancer Risk in Cystic Fibrosis: A Patient Shares Her Experience

By Anna Payne

Thank you to the Cystic Fibrosis Research Institute for letting us share this blog with our audience!

Last year, at the age of 34, I was living in a place of hope. I was thriving on Trikafta, working full time, serving as elected Supervisor for Middletown Township in Bucks County Pennsylvania, and acting as Vice-Chair of the Pennsylvania Rare Disease Advisory Council. For the first time in a long time, I had hope for a future of a “healthy” life. I had big dreams and a lot of things I wanted to accomplish. But then I found a mass in my groin, and after a long, painful and circuitous diagnostic journey, that included numerous invasive tests and long waits between them, I received the news no one wants to hear. “You have Stage 4 colon cancer.”

Known as the “silent cancer,” colorectal cancer remains the third leading cause of cancer-related deaths in the U.S. among the general population. Those with cystic fibrosis have a significantly higher risk of colon cancer than the general population. For those with CF who have not had a transplant, their risk of colon cancer is five to ten times higher, while individuals with CF post-lung transplant have twenty times the risk as the general population.

What makes us especially vulnerable is that colon cancer symptoms can and often do mimic issues that we CF survivors experience daily. More research is needed to determine exactly why we’re at such elevated risk for the disease, but it’s believed to be linked to a mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene.

The most effective tool for preventing this silent disease is a colonoscopy. Colon cancer always starts in the form of polyps, which if found early can be removed prior to becoming malignant. Colonoscopies are recommended for the general population at 45, yet despite our highly elevated risk, the current recommendation for a first screening colonoscopy for a person with CF is 40. That’s too late and must change. Screenings can prevent about 60 percent of colorectal cancer deaths.

I was 34 years old when diagnosed; I had few symptoms and no known family history. Colon cancer grows slowly, and it’s possible it’s been in me for years. I initially sensed that something was wrong when I had minor digestive issues. They persisted, but I second-guessed myself. Then I found a mass in my groin about the size of a dime.

After an inconclusive ultrasound, and while waiting for an appointment with a general surgeon, the lump grew to the size of a walnut. I went to my CF team for help. They found a bowel blockage, a common condition for those with cystic fibrosis known as Distal Intestinal Obstruction Syndrome, or DIOS. We hoped a colon cleanse would clear the blockage, but deep down I knew it was something more serious.

After a CAT scan and a biopsy of the groin mass, came the bad news. Cancer. I burst into tears. A PET scan then revealed the cancer had spread to other organs, including my ovaries, liver – which had 14 lesions – and lymph nodes.

After thriving on modulators, I have been transformed by cancer back into that sick, little vulnerable girl with CF who spent many nights curled up in a hospital bed, unsure of her future. I am now undergoing aggressive chemotherapy, requiring me to be outfitted with a take-home pump. Five times a week, I’m hooked up to an IV pole at home, on fluids to help me re-hydrate. Chemotherapy leaves me fatigued and immunocompromised, susceptible to infections and viruses that can be deadly.

Naturally, that’s required me to adjust my social life, relying on a network of friends. Work has taken a backseat to the battle at hand, but my supportive employer allows me to work remotely — as much as I’m able. My wonderful colleagues have carried the load in my absence. I miss them. I’ve even come to miss the 45-minute commute to my office with a stop to get a hot tea at Dunkin’.

Simple joys like eating — which most of us take for granted — are now a chore. I eat for calories, not pleasure. My diet changed drastically, and I no longer enjoy foods I’d grown up eating, such as macaroni and cheese and steak. If you looked in my cabinets now, you’d mainly find massive amounts of Fruit Loops and Apple Jacks.

I was shocked when my platinum blonde hair – with blue streaks – fell out in clumps. Losing hair is traumatic – it’s about body image, one’s sense of self, and feeling normal. Many have told me not to worry, that it will grow back, but I have no idea how long I will be on chemo, and whether that is true. While I have multiple wigs that allow me to feel like a different superstar each day, and a wide array of knitted hats, I often scrap these so I can emulate my idol, the Rock.

As a little girl, I spent a lot of time inpatient at St. Christopher’s Hospital for Children in Philadelphia. Watching the Rock on the weekly Smackdown was a great escape. Amazingly, the Rock learned about my diagnosis and sent me a heartfelt video wishing me luck in my fight. It’s been viewed millions of times on his Instagram page, and has allowed me to feel less isolated, with a virtual connection to countless people who channel their positivity toward me.

Prior to my diagnosis with colon cancer, I planned to travel across the globe. I wanted to hold a koala bear in Australia and visit Costa Rica. I planned to run for higher elected office. I had hopes and dreams that have been put on pause. I live in a world of uncertainty. Once again, I am learning to be comfortable living in the uncomfortable.

As science improves and evolves, so should our thinking. Cancer screenings must become a normal routine for cystic fibrosis adults, and the sooner the better. My hope is that the recommended age for a first colonoscopy will be lowered to 25 years for those with CF.

But you don’t have to wait for that to happen. If you have symptoms, don’t write them off as the usual CF GI issues. Go and get screened. You may end up saving your own life.

 

Image credit: David Sánchez-Medina Calderón from Pixabay
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Fried Chicken, Colon Cancer, Kentucky, and Everything In Between

By Parker Lynch

According to the national census data for 2020, Kentucky was found to have the highest incidence of colorectal cancer (CRC) in the country—41.2 new cases of CRC per 100,000 people in the state  that year. This number is concerning, especially when comparing it to other states with significantly lower rates: Utah, Colorado, Delaware, Arizona, and Vermont (about 20 new cases per 100,000 in 2020). 

Why Is CRC Incidence High in Kentucky?

There are several risk factors associated with CRC: tobacco use, poor dietary habits, lack of exercise, genetic predispositions, etc. Unfortunately, the residents of Kentucky exhibit each of these poor lifestyle habits much more than other states. Two-thirds of adults in Kentucky are overweight, less than a tenth eat a sufficient amount of fruits and vegetables, and more than a third are not getting enough exercise. On top of these, family history of CRC is common among many families in the state, making it much more likely for individuals to develop the disease. 

On a national level, Kentucky is known for having some of the poorest diets, which includes a regular consumption of fried foods, meats, and bread. Fried foods and over-processed meats, in particular, can expose one’s body to carcinogens that have been linked to CRC as well as various other cancers. 

Kentucky Culture 

Born out of Corbin, Kentucky, Colonel Sanders’ fried chicken restaurant quickly grew to become a very popular and profitable chain of fast food spots. Known for serving bowls, pot pies, mashed potatoes, and loads of fried chicken, KFC has been a hot-spot since the 1940s. It might seem like an easy fix to tell residents to just “eat healthier”, but unhealthy diets that are deeply ingrained in a state’s culture and history are very hard to just simply eradicate. 

Telling residents of Kentucky to stop eating their fried foods is like telling residents of New York to stop drinking coffee; they may just laugh in your face. Changing the standard American diet and encouraging healthy eating habits remains a challenging endeavor for healthcare workers, researchers, community educators, and the population itself. 

Educating Communities

For starters, access to dietary and lifestyle counseling should be expanded throughout all states in America. In doing so, people would inherently have the opportunity to reflect on their own eating habits, and create plans to maximize their nutrient intake, while also learning how to be financially feasible in doing so. Many people may not even be aware of the significant health consequences of their dietary habits, and they will never know unless people are intentionally educating communities about these crises. 

People don’t need to entirely restrict certain foods in order to avoid CRC, but a gradual decrease of the consumption of fried/heavily processed foods while simultaneously increasing the consumption of vegetables, fruits, and leaner meats will lead to a new culture: one where CRC is not a common disease in one’s community or town. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Picture credit Larry White from Pixabay.

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Can Kitchen Utensils Raise the Risk of Colon Cancer?

As the year draws to an end, people often make resolutions related to their money, health, spirituality, and overall personal development for the upcoming year. However, the kitchen is a crucial area that one might want to consider when making New Year resolutions. Yes, you read correctly—the kitchen. Research has indicated that cookware may increase the risk of colorectal cancer (CRC). 

Microplastics Increase the Risk of CRC

Microplastics (which result from the breakdown of plastics), for example, have been shown to cause physiological changes in the gut that can increase the risk of CRC, especially in those under 50. Several research studies have shown that microplastics can reduce the thickness of the mucus lining in our intestine, thereby reducing its barrier function. This could increase access of pathogenic bacteria and toxins to the inner layer of the colonic mucus, potentially increasing the risk of CRC. Interestingly, the authors point out an association between the time when plastic use infiltrated our daily lives, and the risk of CRC.

In the U.S., adults have been estimated to ingest between 39,000 and 52,000 particles of microplastics annually, and an additional 90,000 particles if they drink bottled water. 

While plastics are biochemically inert, plasticizers used in their processing may be the source of the biological impact. Their resilience and stability has led to the environmental accumulation of plastics across our planet and they are now a part of the human food chain. 

Risk from Non-stick Coatings on Pots and Pans

Another study has found an association between CRC risk and a chemical called perfluorooctanoate (PFOA) in a specific population in New Hampshire. What is PFOA, you ask? Informally called a “forever chemical”, PFOAs were—and maybe continue to be—used in certain cookware, particularly non-stick pots. Safe cookware includes titanium, enamel iron cast, clay, glassware, and non-stick pots with the word “no PFOA”  indicated on them. Aluminum cookware, however, is just as unsafe as non-stick pots containing PFOA. However, research in an Appalachian population has found an inverse relation between PGOA and CRC development. Additional studies will be needed to ascertain the relation between these chemicals and CRC development.

These studies confirm some of the health risks associated with our daily exposure to certain environmental factors.

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Photo credit: S’well on Unsplash

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Holiday Card Uses Humor to Send Serious Message About Colon Cancer Screening

By Matthew Tolzmann

Twenty years ago, my dad was diagnosed with stage 3B colon cancer. He was 60 years old, and he had scheduled his first-ever colonoscopy schedule—but he required colon cancer surgery before the day of his scheduled screening. My dad started chemotherapy, but landed in the hospital when the treatment nearly killed him. A pastor by profession, the only time he didn’t feel nauseous for his year of chemotherapy was when he was preaching.

My dad is a cancer survivor of twenty years now. I’m so grateful that he was given these twenty years and counting, but I feel bad that he had to go through that year of hell. I’m positive that if he were to have had a colonoscopy at age 45, he would never have needed that year of chemotherapy.

Because of this family history, I am considered high risk and my doctor recommended that I have my first colonoscopy when I was 35. My dad actually gave my brother and I colonoscopies for Christmas presents that year! My dad was willing to pay whatever it cost, to save us from what he endured, but I was fortunate that my insurance covered everything. When I was 35, I had incredible insurance through my employer and my first three colonoscopies were covered with basically no extra cost to me. My insurance changed to a marketplace plan and it appeared I was going to have to pay quite a bit because all of my colonoscopies are considered “diagnostic.” The insurance, however, ended up covering most, if not all, of the cost. I was amazed. My insurance has changed again, so in another few years I’ll see if it’s still covered!

Editor’s note: Additional information about screening guidance and insurance coverage can be found here.

My first screening colonoscopy showed several precancerous growths that the doctor removed right then and there. Over the next 15 years, I had three more colonoscopies. The most recent one, at age 50, for the first time ever, resulted in a clean scan with no growths to remove whatsoever. I am positive that colonoscopies have saved me from what my dad went through, or worse.

I’ve had two friends pass away from colon cancer and each death really affected me. In their memory and in honor of my dad, we sent out holiday cards with a call to action to get screened for colon cancer. I love sending out irreverent and creative holiday cards that make people smile, but I felt really good about the higher purpose of this year’s card. If my card can get even one person to get screened and they find even one growth… Then that could translate to one life extended by twenty years… or thirty… or forty…

 

Matthew has a Bachelor’s of music in Music Theory & Composition from the University of Northern Colorado. He has been the violin photographer for Bein & Fushi Rare Violins since the year 2000 and has photographed some of the world’s most valuable stringed instruments. Matthew is also an author and an artist and is currently writing and illustrating a nature science book as well as several collections of humorous essays. He lives in Chicago with his wife, Andrea, and his youngest son, Peter. His oldest son, Simon, is in college in Colorado.

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Reviewing CRC From an Anthropological Lens: Who Is Most At Risk and Why?

By Parker Lynch

One cannot deny the importance of considering an individual’s risk of colorectal cancer (CRC) on the basis of their diet, exercising habits, and genetic predispositions. However, many other demographic factors can influence the likelihood of being diagnosed with CRC, as well as subsequent quality of life and survival outcomes. 

Lower socioeconomic status, for instance, is associated with a very high risk of developing CRC. Most of these community members are uninsured, which makes it difficult for them to receive the screenings that are otherwise readily accessible for those with insurance plans. A colonoscopy (one of the most important preventative screening measures for CRC) can cost anywhere from $500 to $6,000 without insurance, depending on the site where the procedure is conducted. For those on tight budgets, paying such amounts out-of-pocket every 5-10 years (depending on their personal risk of CRC) is quite unrealistic.

Tampa Bay Study

In a retrospective study conducted in 2021 by the CDC, researchers analyzed 13,982 uninsured patients with CRC who had received services at various free clinics in the Tampa Bay area between 2016 and 2018. These patients’ demographics are as follows: 

  • 5,139 (36.8%) were aged 50 years or older
  • Most were female (56.8%)
  • A large majority were non-Hispanic White (41.1%)
  • Majority were unemployed (54.9%)

Less than 7% of these patients had received any sort of preventive colorectal screening in their lives. 22.7% of these patients were smokers, and another 28.3% had diabetes. Not only are these patients more at risk for CRC because of their predisposed comorbidities, but they also don’t have the means to receive proper preventative screenings.

Bridging the Gap: Free Clinics

This study is one of many that sheds light on the healthcare treatment discrepancies among people of different socioeconomic statuses in America. The concerning statistics presented by these retrospective studies have motivated healthcare professionals and non-profit organizations to provide free clinics across the U.S. to make screening accessible to those who wouldn’t be able to otherwise afford it.

The NYC Health Department’s NYC Community Cares Project, for instance, provides free colonoscopies for uninsured residents referred from primary care sites. This program collaborates with various endoscopy centers and allows patients to work with primary care physicians, while also receiving free anesthesia and pathology services. Other interventions, such as the ColonoscopyAssist program, assists uninsured individuals in 30 states with the fees associated with CRC screening. This organization strives to eradicate a lot of the costs that are accumulated when someone gets preventative screening done, and reduces a colonoscopy’s cost to around $1,000 for a patient. Though this program doesn’t entirely eradicate colonoscopy costs, it still helps patients by significantly reducing the price, inherently making them much more feasible. 

Moving Forward

These public health interventions are vital to treating patients that suffer from America’s healthcare inaccessibility issues that run rampant throughout the country. Even though the U.S. spends more money on healthcare than any other wealthy country in the world, we have struggled to match other countries in patient satisfaction, accessibility, and life expectancy. 

Movements like the Community Cares Project in NYC, ColonoscopyAssist program, and other free/reduced-cost screening resources across the country are making huge strides in the CRC community. Should these endeavors continue to be subsidized by non-profit organizations, philanthropies, donations, and government support, uninsured individuals can receive timely preventative screenings. Increased access to these resources can ensure that patients from all socioeconomic backgrounds can receive the care that they need. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

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Do You Have Diabetes? You Might Be At Risk for Colon Cancer 

By Parker Lynch

There are several known risk factors for colorectal cancer (CRC): genetic predisposition, age, poor diet, lack of regular physical activity, high alcohol consumption, etc. Recent research is further indicating that other health conditions could also influence an individual’s risk for developing CRC. One such condition is type 2 diabetes, was previously discussed by Emma Edwards (an intern colleague at the Colon Cancer Foundation) in a previous blogpost.

Someone with type 2 diabetes typically has hyperinsulinemia, meaning that they have too much insulin in their blood. Research shows that these higher levels of insulin and sugar in one’s body creates an environment in which CRC can develop more readily. Additionally, higher levels of sugar in the bloodstream typically contributes to more inflammation, which also increases CRC risk. The two factors together mean that someone with type 2 diabetes has a 27% greater chance of developing CRC. 

Severity and Oncological Outcomes

Knowing that there is a link between diabetes and CRC, researchers wanted to specifically hone in on patients with both conditions to understand whether severe diabetes has an impact on CRC survival. 

In a Taiwanese study published in October 2023, data from the country’s Cancer Registry Database was retrospectively analyzed for the period between 2007 and 2015. The 59,202 patients included in this study had diabetes and had undergone curative radical resection for their CRC (stages Ⅰ-Ⅲ), meaning that they had surgery to completely remove their cancerous tumors. The study split the population into three groups: 

  • CRC patients with diabetic complications
  •  CRC patients without diabetic complications
  • CRC patients without diabetes

After conducting the retrospective research, it was found that those with uncomplicated diabetes had an insignificantly worse CRC survival (better survival rates), whereas those with complicated diabetes had a significantly higher risk of poor survival. Women with diabetes, in particular, suffer from more negative CRC outcomes than their male counterparts. These findings indicate that patients who don’t experience diabetic complications will have better CRC outcomes in terms of survival.

One Step At a Time

Managing diabetes alone is a lot of work. Patients must constantly manage their diet, blood glucose levels, physical activity levels, etc. Dealing with CRC on top of diabetes seems impossible. However, patients are encouraged to take their afflictions one step at a time, with the support of their healthcare team by their side, composed of both oncology specialists and endocrinologists. 

Maintaining blood sugar levels and minimizing possible diabetic complications can have a positive impact on CRC outcomes. Though colon cancer and diabetes seem like vastly different conditions, they can go hand-in-hand and should be considered together when developing a treatment plan. 

 

Parker Lynch is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

 

Photo credit: Towfiqu barbhuiya on Unsplash.

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Gut Microbes Play an Important Role in Colorectal Cancer

By Emmanuel Olaniyan

Colorectal cancer (CRC) is one of the more common types of cancer and is the third largest cause of cancer-related deaths worldwide. According to the American Cancer Society, 153,020 new cases of CRC are expected to be detected throughout the U.S. in 2023, out of which 52,550 people will die from the disease. Considering these figures, it is important to raise public awareness about CRC in order to decrease the number of CRC-related deaths and new cases.

Several studies have researched the causes of CRC, and age, diet, genetics, and the gut microbiota have all been identified as risk factors in various ways. The gut microbiome, in particular, has been shown to play an important role in a number of diseases, and research has begun to focus heavily on its role in CRC. 

What is the Gut Microbiome?

The human gut microbiota refers to the trillions of microbes, such as bacteria, viruses, fungi, and others present in the human digestive tract. The microbiome is the environment they live in. Most microbes in the body are beneficial, but they may become harmful when out of balance.

The gut microbiota is crucial for the overall functioning of a healthy digestive system because it supports the absorption of energy from digested food, guards against pathogens, controls immunological response, and fortifies biochemical barriers of the intestine. However, when harmful bacteria enter the gastrointestinal tract through eating contaminated food or drinking contaminated water and cause infection, all of these advantageous activities could be disrupted.

Jaeho Kim and Heung Kyu Lee published a study in 2022 that found a strong association between gut microbiota and CRC. They came to the conclusion that the patients with CRC experienced dysbiosis (an imbalance in bacterial composition, changes in bacterial metabolic activities, or changes in bacteria distribution within the gut) more frequently than healthy individuals. Opportunistic infections were discovered to be more prevalent, and intestinal inflammation has been shown to be reduced along with the percentage of bacteria that produce butyrate, which is an essential component of our digestive system that reduces inflammation in the digestive tract, protects the brain and prevents cancer.

How Can We Maintain a Healthy Gut Microbiome?

Maintaining good hygiene and being mindful of the foods we eat can help keep our gut microbiota healthy. Studies have shown that eating more processed foods and a low intake of dietary fiber increase the risk of CRC. For this reason, it is recommended to consume fermented foods like cheese, soy sauce, vinegar, and yogurt as well as meals high in fiber like whole grains. It has been established that the bacteria present in these fermented foods are similar to those linked to gastrointestinal health. 

Finally, a decrease in processed food consumption and antibiotic use lowers the risk of developing CRC caused by gut microbes. 

 

Emmanuel Olaniyan is a Colorectal Cancer Prevention Intern with the Colon Cancer Foundation.

Image source: OpenClipart-Vectors from Pixabay

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Rise in CRC Among Young Adults Continues to Baffle Researchers

Cancer incidence has been growing among younger adults—not just in the U.S., but globally. According to a recent analysis, the three decades between 1990 and 2019 saw almost an 80% increase in incidence of early-onset cancer. Following breast cancer, cancers of the digestive tract (stomach and colorectal) have seen a rise among young adults—in 2019, 37% of early-onset cancers diagnosed across the world were in the colon and rectum.

These trends are also reflected in the U.S. population. Here’s a startling prediction: by the year 2040, colorectal cancer (CRC) is estimated to be the second-leading cancer in the 20-49 age group and the top cause of cancer-related death in that age group.

The Need to Raise Awareness Among Providers

What is frustrating for the early-age onset CRC (EAO-CRC) community is that young individuals are not your typical candidate for developing colon cancer, which means their symptoms are either dismissed or attributed to some other gastrointestinal issue. According to cancer epidemiologist Yin Cao, 50% of EAO-CRC cases are among those under 45 years of age. Current guidelines recommend that someone with an average risk for CRC should start screening at age 45, so anyone younger may not get screened despite their symptoms.

An average-risk person is someone who does not have a known family history of CRC or a known genetic condition that’d increase their risk for developing CRC.

As a result, diagnosis is delayed, which raises the risk of an advanced-stage disease that may be harder to treat. One such study among nearly 1,200 EAO-CRC patients found that 71% were diagnosed at an advanced stage (stage III or IV).

*Information on the various stages of CRC can be found here.

What’s Leading to the Rise in EAO-CRC?

While there are a lot of guesses, researchers and clinicians are not quite sure. There are talks about a birth cohort effect, which is a term that describes the unique experiences or exposures faced by a group of individuals based on their year of birth. For example, Americans born prior to 1945 have been found to have a lower risk of being obese.

Going back to CRC, medical oncologist Christopher Lieu told ScienceNews that those in their 40s today are at a greater risk of developing CRC than those who turned 40 a decade ago (so now in their 50s). Several different risk factors are being investigated in those who develop EAO-CRC:

  • Obesity
  • Antibiotic exposure
  • Changes in the gut microbiome (meaning the microbes that live in our gastrointestinal tract)
  • Dietary habits
  • Environmental exposures

However, there’s no definitive answer for the cause. The best preventive efforts include being physically active, managing your body weight, reducing the intake of processed food and integrating fresh fruits and vegetables in your diet.

What Do We Know?

What is definitely known are the telltale symptoms: pain in your abdomen, abnormal bowel movements (unexplained diarrhea or constipation), blood in your stools/rectal bleeding, unexplained weight loss, weakness. It is important to pay attention to these symptoms, which are often misdiagnosed as inflammatory bowel disease or hemorrhoids, especially in young adults. Any two of these signs could indicate a serious problem with your gastrointestinal tract—potentially, cancer.

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