• Bowel cancer, or colon cancer, is currently the third most common cancer in the world.
  • Cases of colon cancer in younger adults are on the rise in many areas of the world.
  • Bowel cancer screenings are important to help detect the disease at its earliest stage.
  • Researchers have identified a protein in the immune system that could be used as a biomarker during colon cancer screenings and potentially slow progression of the disease.

Bowel cancer — also known as colorectal cancer or colon cancer — is currently the third most common cancer in the world.

Although colorectal cancer is treatable when caught in its earliest stages, only about 35% of all cases are diagnosed at the earliest stage.

Past studies show colon cancer recurrence affects between 30–40% of people treated for this type of cancer.

For this reason, bowel cancer screenings are important to help detect the cancer at its earliest stage.

Researchers at the Australian National University are helping to provide an additional biomarker for future use in improving outcomes at every stage of disease spread.

This specific protein in the immune system, Ku70, can be manipulated to potentially treat colon cancer. The findings were recently published in the journal Science Advances.

Dr. Si Ming Man, group leader and CSL Centenary Fellow in the Division of Immunology and Infectious Disease at the Australian National University and corresponding author of this study explained why it’s important for researchers to continue searching for new ways to treat bowel cancer.

“Despite the progress in developing novel therapeutics, bowel cancer is the [third] leading cause of cancer-related deaths worldwide,” Dr. Man told Medical News Today.

“Given the high mortality and increasing incidence — especially in the younger population [adults under 50] — improvements in existing therapies and/or the development of more effective and safer therapeutics are needed for patients with colorectal cancer.”

Researchers estimate there were about 1.93 million bowel cancer cases globally in 2020, and that number is expected to hit 3.2 million in 2040.

Cases of colorectal cancer in younger adults are also on the rise in many areas of the world, including the United States, the United Kingdom, Europe, and China.

When asked why they decided to look for a protein in the immune system as a way to help prevent and even treat colorectal cancer, Dr. Man said scientists have known for a long time that the immune system can pick up and destroy cancer cells.

“Therefore, harnessing and boosting the power of the immune system could be a safe approach to restricting the development of cancer,” Dr. Man explained.

“This vision led to the identification of a remarkable immune protein that can guide the therapeutic decisions for patients with colorectal cancer.”

For this study, Dr. Man and his team focused on a protein called Ku70.

“Ku70 is an immune protein that functions as a repair worker and fixes any breaks or damage in our instruction manual, called DNA,” Dr. Man explained.

“In this study, we observed that people with bowel cancer carry less Ku70 proteins in their body and are more likely to die from their disease earlier in life, suggesting that the amount of Ku70 could be used as a biomarker in predicting the prognosis of colorectal cancer.

Further, we observed that Ku70 works like a surveillance system that picks up damaged DNA and works with other immune proteins called Ras and Raf, which are frequently altered in colorectal cancer, to stop healthy cells from turning into cancer cells.”

— Dr. Si Ming Man, corresponding study author

Looking to the future, Dr. Man said that investigations into the precise source and feature of DNA involved in Ku70-mediated activation of Ras and Raf could guide the development of new therapeutics, improving the treatment outcomes for individuals with inflammatory diseases and cancer therapeutics.

“Potential future directions of this study are to test whether Ku70 works in the same way in other cancers,” he added. “ Investigations into activating Ku70 using small-molecule drugs and/or DNA-based therapy are another potential avenue.”

MNT also spoke with Dr. Anton Bilchik, surgical oncologist, chief of medicine, and director of the Gastrointestinal and Hepatobiliary Program at Saint John’s Cancer Institute in Santa Monica, CA, about this study.

Dr. Bilchik said he found the study to be both exciting and provocative because it identifies a specific signaling pathway within a cell which, if suppressed, enhances the progression of cells that can become colon cancer.

“And then the opposite occurs if there is an increase in the particular mutation or expression of these genes,” he added.

“So the relevance of these findings is that it identifies a specific signaling pathway that can potentially be targeted for treatments for colorectal cancer.”

“And we’re seeing an epidemic of young people — young adults under age 50 — with colorectal cancer,” Dr. Bilchik continued.

“So any information that provides insight as to what causes colorectal cancer, and this study simply suggests a particular signal or pathway that may lead to colorectal cancer, as well as inflammatory bowel disease, is extremely important.”

As to why bowel cancer rates among young adults are on the rise, Dr. Bilchik said the common global themes are obesity, alcohol, and smoking.

“And what has been noticed is that in certain countries where there is a decline in alcohol use, such as France and Italy, there is stability or even a decline of younger people being diagnosed with colorectal cancer,” he detailed.

“Unlike other countries, such as the U.K. or Northern Europe, where alcohol intake — and I’m talking specifically among younger adults — is on the rise, there is a high incidence of early-onset colorectal cancer versus late onset, meaning after age 50.”

Dr. Bilchik said the next steps for this research should be to define better which particular cells are most relevant.

“Two of the known causes of colorectal cancer relate to the microbiome, which is the bacteria within the body, as well as the immune system. So, more studies show how this impacts the microbiome and the immune microenvironment. And then what would be most interesting is to see what potential drugs may enhance the expression or decrease the expression.”

— Dr. Anton Bilchik, surgical oncologist

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