Why are young people getting colorectal cancer?

Research will accompany the Vanderbilt-Ingram Cancer Center Young Adult Program, delving into three very important questions about colorectal cancer: why these cancers are happening at such a young age; why survival is shorter in young adult patients; and whether these young patients should be receiving the same treatments as older patients with colorectal cancer.

“All of the research being conducted has largely been in the patient of average age for colorectal cancer,” said Cathy Eng, MD, FACP, FASCO, professor of Medicine, David H. Johnson Professor of Surgical and Medical Oncology, co-director of GI Oncology, co-leader of the Vanderbilt-Ingram Gastrointestinal Cancer Research Program and director of the Vanderbilt-Ingram Cancer Center Young Adult Program.

The majority of colorectal cancers occur in people over 50. For colon cancer, the average age at the time of diagnosis for men is 68, and for women, 72. For rectal cancer, it’s 63 for both men and women.

“We don’t understand why survival in young adult patients with colorectal cancer is shorter than older patients,” Eng said. “From a GI perspective, there’s something unique about these patients.”

Eng said that FDA-approved therapies used to treat colorectal cancer in patients are largely geared toward the

average age patient population. With the development of the Young Adult Program, Vanderbilt-Ingram is also building a young adult database to capture information about its young adult patients. For those who opt in to the database, urine specimens will be collected, and investigators will look at microbiology and residual tissue captured in biopsies for molecular sequencing.

“At the end of the day, we’ll need a large number of these young patients to capture additional information, but if we start early on, we can look at the benefits of treatment, the cost benefits in regard to their treatment and the psychosocial barriers our young adult patients are facing,” she said. “It’s an amazing opportunity to look at the young adult patient from multiple facets.”