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Could Gut Bacteria Be the Missing Link in Early-Onset Colorectal Cancer?
Colorectal cancer (CRC) is increasing in people under 50 years old, and it has researchers wondering, “What’s going on?”
Interestingly, CRC rates are dropping overall, especially in older adults, but the number of younger adults (under 50) diagnosed with colorectal cancer has nearly doubled since the early 1990s. In the U.S., for example, the rate increased from 8.6 cases per 100,000 people in 1992 to 12.9 per 100,000 in 2018, with the most significant jump occurring in the 40-to-49 age group. Similar trends are occurring worldwide, leaving researchers puzzled about the cause of this phenomenon.1
What makes this rise puzzling is that most younger adults diagnosed don’t have the usual suspects – no family history of colorectal cancer or polyps, and no hereditary syndromes. Scientists are now turning their attention to something that’s been gaining ground in cancer research: the gut microbiome.
Bacteria: A Potential Player
Our gut is home to trillions of bacteria that help digest food, regulate our immune system, and maintain a healthy metabolism. But sometimes, this bacterial community gets out of balance, a condition called dysbiosis. Dysbiosis can reduce bacterial diversity, allowing harmful bacteria to take over, which may increase the risk of cancer.
Certain bacteria have been linked to colorectal cancer across all ages. For example, Fusobacterium, a germ more commonly found in the mouth, has been discovered inside colorectal tumors. This bacterium can sneakily promote cancer by messing with cell signaling and weakening the immune system’s ability to fight tumors. Other troublemakers include Bacteroides fragilis, Streptococcus gallolyticus, and Helicobacter pylori.1
Researchers are thinking outside the box and looking at risk factors like diet, obesity, antibiotic use, and even how you were born (vaginally or by C-section) to find out what can influence the makeup of your microbiome from birth onward. They’re wondering if these factors might nudge the microbiome toward dysbiosis, potentially increasing the risk of colorectal cancer over time.
Digging deeper, scientists recently studied the DNA mutations found in nearly 1,000 colorectal cancer tumors from 11 countries to better understand the mutation patterns. They noticed that certain mutations appeared to be associated with bacteria residing in the colon, particularly a compound called colibactin produced by specific bacteria.2
Colibactin is a mutagen, meaning it can damage DNA by creating bulky chemical attachments that lead to mutations in cells lining the colon. One particular mutation signature, known as SBS89, appears early in life in some colorectal cells but then ceases to accumulate. Researchers believe this signature originates from colibactin or similar bacterial mutagens, indicating that some DNA damage occurs early in life due to the presence of our microbiome inhabitants.2
Why does this matter? Early DNA damage in cells lining the colon could give those cells a “head start” toward becoming cancerous years or even decades later. For instance, colibactin-induced mutations may inactivate a key tumor suppressor gene called APC, a common early step in colorectal cancer development. This early hit could explain why some younger adults develop colorectal cancer without the usual risk factors.
Your Call to Action
The rise in early-onset colorectal cancer is a wake-up call. Since bacteria in our gut may play a bigger role than previously thought, paying attention to gut health and getting screened on time becomes even more critical.
If you have a family history of bowel diseases or colorectal cancer, or if you’re experiencing symptoms like unexplained changes in bowel habits, blood in stool, or persistent abdominal pain, don’t wait. Discuss screening options with your healthcare provider. Early detection saves lives.
At MASJax, we’re committed to supporting your colorectal health through personalized screening and education, especially if you have a family history or other risk factors. Remember, colorectal cancer is often preventable and highly treatable when caught early.
Schedule your colorectal cancer screening with MASJax today.
- Dharwadkar, P., Zaki, T. A., & Murphy, C. C. (2022). Colorectal Cancer in Younger Adults. Hematology/oncology clinics of North America, 36(3), 449–470. https://doi.org/10.1016/j.hoc.2022.02.005.
- Díaz-Gay, M., Santos, dos, Moody, S., Kazachkova, M., Abbasi, A., Steele, C. D., Vangara, R., Senkin, S., Wang, J., Fitzgerald, S., Bergstrom, E. N., Khandekar, A., Otlu, B., Abedi-Ardekani, B., Carolina, A., Cattiaux, T., Cortez, R., Gaborieau, V., Chopard, P., & Carreira, C. (2025). Geographic and age variations in mutational processes in colorectal cancer. Nature, 643, 230–240. https://doi.org/10.1038/s41586-025-09025-8.
