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, one of the largest cancer research and treatment organizations in the United States, may have developed a novel blood test that can be used to detect early-onset colorectal cancer, which has been on the rise in younger adults in recent years.

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

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.

“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.”

The study “A liquid biopsy signature for the detection of patients with early-onset colorectal cancer” was published in Gastroenterology. The research was supported by grants from the National Cancer Institute, National Institutes of Health (CA72851, CA181572, CA184792, CA202797 and CA227602) as well as from Fundación Mapfre Guanarterme.

About City of Hope

City of Hope's mission is to deliver the cures of tomorrow to the people who need them today. Founded in 1913, City of Hope has grown into one of the largest cancer research and treatment organizations in the U.S. and one of the leading research centers for diabetes and other life-threatening illnesses. As an independent, National Cancer Institute-designated comprehensive cancer center, City of Hope brings a uniquely integrated model to patients, spanning cancer care, research and development, academics and training, and innovation initiatives. Research and technology developed at City of Hope has been the basis for numerous breakthrough cancer medicines, as well as human synthetic insulin and monoclonal antibodies. A leader in bone marrow transplantation and immunotherapy, such as CAR T cell therapy, City of Hope’s personalized treatment protocols help advance cancer care throughout the world.

With a goal of expanding access to the latest discoveries and leading-edge care to more patients, families and communities, City of Hope’s growing national system includes its main Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, scheduled to open in 2022, and Cancer Treatment Centers of America. City of Hope’s affiliated family of organizations includes Translational Genomics Research Institute and AccessHope^TM. For more information about City of Hope, follow us on Facebook, Twitter, YouTube, Instagram and LinkedIn.

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