Unlocking the potential of biomarkers for colorectal cancer

1 in 23. Those are the odds in 2022 for men of developing colorectal cancer in their lifetime, according to the American Cancer Society. The odds only slightly improve for women, with the current risk rate at 1 in 25.

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 52,000 lives in the United States this year alone, requires more than new treatment options.

That’s why a 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, they 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. The study, which was published 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 the Baylor Scott & White researchers started. They 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?

They decided to look in the codebook of the human body — genes — for the answers.

The genetic roadmap to cancer risk

Using a model they had used in other studies, such as one for pancreatic cancer, the team 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, they 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 doctors can take one biopsy, when someone is in their twenties or thirties, and immediately know that person’s risk for colorectal cancer now or down the road. This knowledge allows medical professionals to understand that person’s needs and be more proactive with care.

This means that not only could doctors more effectively identify at-risk patients and create more refined treatment options, but the quality of life for thousands of other ulcerative colitis patients could also be improved. Instead of ongoing monitoring and a lifetime of biopsies just in case they someday develop colorectal cancer, patients could be offered customized treatment options according to their individual risk level.

Understanding the mystery of mRNA biomarkers

Researchers always are motivated by these results, but in the future, the Baylor Scott & White team plans to take it one step forward: Can they 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?

While detection and surveillance are important, researchers 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. This could give medical professionals 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 a single biopsy.

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