Researcher Q&A: Why is colorectal cancer more dangerous in the young?

Angus reports on the basic research, clinical science, and drug development that may transform survival and quality of life for patients, as well as developments affecting the cancer community. You can reach Angus on Signal at angus.08.

For years, scientists have struggled to elucidate key biological differences between early onset colorectal cancer, typically in patients under the age of 50, and older patients. They’ve long believed that these cancers must be biologically distinct, since younger patients tend to be far more difficult to treat. They’re often diagnosed at later stages with tumors with more aggressive features.

“Their survival, especially for the very youngest patients under the age of 35, may actually not be as good as somebody in their 40s or someone in their 60s, despite receiving more aggressive treatment and being at baseline healthier,” said Kimmie Ng, a colorectal cancer researcher and director of the Dana-Farber Cancer Institute Young-Onset Colorectal Cancer Center. “So we have always believed tumors may be biologically different.”

On Thursday, Ng published a new study in Nature Medicine that may help illuminate critical differences between older and younger colorectal cancer patients. With 189 tumors, it’s the largest biological database — what researchers call a single cell atlas — of colorectal cancer tumors in patients ranging from their 20s to their 90s. The atlas, along with the technology Ng and her colleagues used, should help researchers control for variables that confounded studies in the past.

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