Cellular Map of Young-Onset Colon Cancer Offers New Research Path

Scientists at Dana-Farber Cancer Institute, Mass General Brigham, and the Broad Institute published a study Thursday that provides the most detailed biological map yet of colorectal cancer in young adults. The research analyzes 189 tumors to identify specific cellular differences between younger and older patients.

The study, published in Nature Medicine, examined tissue from individuals ranging from their 20s to their 90s. Among the 189 samples, 54 came from patients diagnosed before age 50. Researchers analyzed more than 850,000 individual cells to generate a comprehensive dataset on how the disease manifests in different age groups.

American Cancer Society data shows that colorectal cancer rates among people under 50 rose by nearly 3 percent annually from 2013 to 2022. The disease is now the leading cause of cancer death in this demographic. Previous research focused on external risk factors such as diet and ultra-processed foods, but this new work addresses the internal biology of the tumors.

Ana Anderson, a senior author and core faculty member at the Gene Lay Institute of Immunology and Inflammation at Brigham and Women’s Hospital, described the previous understanding of the disease as a black box. She stated that the new data provides a research direction and a path to find specifics that could lead to tailored therapies for young-onset cases.

The researchers found that tumors in younger patients contain a higher proportion of stromal cells, which are connective and supporting cells. Other solid cancer studies have linked stromal cells to resistance to chemotherapy. The team also observed differences in gene expression within the tumors of younger patients, a finding that could point to new therapeutic targets.

Kimmie Ng, director of the Young-Onset Colorectal Cancer Center at Dana-Farber and a senior author, noted that this is the largest dataset of its kind for colorectal cancer. She said the data serves as a guidepost for future research efforts. John Paul Shen, an associate professor at the University of Texas MD Anderson Cancer Center who was not involved in the study, said the data allows for clear experiments in labs around the world.

Christina Annunziata, senior vice president of extramural discovery science at the American Cancer Society, called the dataset an essential first step. She emphasized that the research is necessary to understand why people are getting cancer early and what can be done about it. The study cohort aligns with general knowledge of young-onset patients globally, though experts noted the sample size is limited in terms of the total number of people involved.