According to a new study from the Cleveland Clinic, certain diet-derived chemicals, or metabolites, have been identified as key contributors to young-onset colon cancer risk—particularly those associated with red and processed meats. In the findings reported in NPJ Precision Oncology, metabolite, and microbiome data show that discussing dietary habits with a doctor may become part of how clinicians prevent colon cancer in adults under 60 years of age.
“We can’t apply the same care models we use for those over the age of 60 to younger adults,” says senior author and gastrointestinal oncologist Suneel Kamath, MD. “We can’t really offer annual colonoscopies to everybody so much as it’s realistic, so realistically it would be something very simple – maybe some kind of test that literally measures some kind of biomarker of risk for the disease – so that one could guide the appropriate amount of screening to those at high risk.”
The findings, led by former clinical fellow Dr. Thejus Jayakrishnan and Dr. Naseer Sangwan, PhD, who directs the Microbial Sequencing & Analytics Resource Core, included extensive patient data analyses from Cleveland Clinic’s Center for Young-Onset Colorectal Cancer. This study, according to the authors, was an extension of previous studies that had shown metabolite and gut microbiome differences between young and old colorectal cancer patients, pointing toward new avenues in the direction of a more advanced understanding of young-onset CRC.
Dr. Sangwan and his colleagues designed an AI algorithm that integrated all of the different data sets for a systems biology analysis. It revealed that a large proportion of variation arising between younger and older patients is explained by dietary components, more specifically metabolites associated with red and processed meat consumption. “While much emphasis has been put on the gut microbiome as a primary driver of colon cancer risk, our data clearly shows that diet is the main driver,” says Dr. Sangwan. “With a clear understanding of the key metabolites that may be linked to young-onset risk, we are in a better position for the targeting of future research.”
The findings suggest that one can pinpoint better who is at risk for cancer, thus pinpointing better at-risk individuals for further exploration, specifically through the use of blood metabolite analysis rather than through the more complex stool microbiome sequencing. “Diet is more readily changeable compared to the microbiome,” says Dr. Kamath. “This realization has influenced my practice, putting priority in my discussions with my patients and their families regarding dietary habits.”
The metabolites that were found at higher levels in the younger patients with colorectal cancer had relations to arginine metabolism and the urea cycle, both of which are closely aligned with long-term red and processed meat consumption. To follow up on this, the team is now using national datasets to confirm these findings and assess whether dietary interventions or specific medications targeting arginine production and the urea cycle may help prevent or treat young-onset colorectal cancer.
Dr. Kamath would be the first to admit that the greatest innovation in the study is how the diet figures so prominently into colorectal cancer risk, and that is a fact to which he has been cavalierly catering ever since incorporating the findings into his approach toward patient care. “The risk from diet concerning cancer was already known, but this study has reinforced the need to talk about it more with patients and their support networks,” he says. “Indeed, the single most crucial weapon in the fight against colorectal cancer is giving patients clear, actionable advice about lifestyle choices.“
ANI
