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Unlocking the potential of biomarkers for colorectal cancer

1 in 21. Those are the current odds for men of developing colorectal cancer in their lifetime. The odds only slightly improve for women, with the current risk rate at 1 in 23.

For people suffering from ulcerative colitis, the risk of developing colon cancer becomes even higher. Fighting this deadly cancer, which is expected to take over 50,000 lives in the United States this year alone, requires more than new treatment options.

That’s why our team of researchers at Baylor Scott & White Research Institute (BSWRI) decided to explore the connection between ulcerative colitis and colon cancer — to find a way to take our efforts beyond treatment and toward a game-changing test for early detection.

In doing so, we have developed what could be a first-of-its-kind screening test to change how the medical community takes on this cancer for decades to come. Our study, which was published recently in Gastroenterology, outlines how further examination of microRNA could hold the secrets to detecting this deadly condition.

Why ulcerative colitis?

There are many risk factors for colorectal cancer, but having a longstanding inflammatory bowel disease (IBD), especially ulcerative colitis (ulcers, or sores, in the colon), can increase your risk by almost 150 percent, according to a study in Digestive Endoscopy.

And because people are typically diagnosed with ulcerative colitis in their twenties and thirties, that’s where we started. We approached the study with two clinical questions:

  • Could we find a better approach to diagnosing patients with ulcerative colitis?
  • Which of these patients face a higher risk of developing colorectal cancer later in life?

We decided to look in the codebook of our bodies, our genes, for the answers.

The genetic roadmap to cancer risk

Using a model we’ve used in other studies, such as one for pancreatic cancer, we first looked at microRNA (mRNA) biomarkers — the keepers of our genetic information — and compared mRNA biomarkers of people with colorectal cancer against the biomarkers of healthy people.

Of the 387 samples examined, we found certain biomarkers were higher in patients with colorectal cancer than in those without.

This discovery has very powerful implications, especially for people with ulcerative colitis. Based on this premise, it’s possible that we can take one biopsy, when someone is in their twenties or thirties, and then immediately know their risk for colorectal cancer now or down the road.

In doing so, we can be more knowledgeable about their needs and proactive with their care.

With this option, we are looking at a means of not only more effectively identifying at-risk patients and creating more refined treatment options, but we’re also helping improve the quality of life for thousands of other ulcerative colitis patients. Instead of ongoing monitoring and a lifetime of biopsies just in case they someday develop colorectal cancer, we can offer patients customized treatment options according to his or her individual risk level.

Understanding the mystery of mRNA biomarkers

We’re motivated by these results, but in the future, we plan to take it one step forward: Can we find the same kind of cancer biomarkers in a person’s blood, rather than through samples from a biopsy? Could predicting colorectal cancer risk be as easy as a blood test for patients with ulcerative colitis?

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While detection and surveillance are important, we also want to understand the mystery behind mRNA biomarkers as a whole — how they work mechanistically, biologically and functionally. After all, they might hold even more untapped information that we don’t even know about yet. This could give us a deeper understanding into how ulcerative colitis and IBD happen in the first place.

While still in its early phases, this test alone is a significant step forward in helping patients receive a better diagnostic approach for ulcerative colitis and developing colorectal cancer, in one single biopsy.

This article was contributed by Ajay Goel, PhD.

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Unlocking the potential of biomarkers for colorectal cancer