An overwhelming wave of emails, many filled with poignant tales of loss and anguish, has inundated our inboxes, compelling us to confront a deeply concerning trend. The majority of these letters arrive from individuals in their 30s and early 40s, all bearing the life-altering news of a bowel cancer diagnosis. We have received hundreds of these accounts, with an alarming number detailing remarkably similar experiences that resonate with distress.
Countless correspondents describe how they overlooked their troubling symptoms—blood in their stools, significant weight loss, and relentless abdominal pain. Tragically, some have had their serious concerns brushed aside by medical professionals who deemed them ‘too young’ to be afflicted by such a devastating illness. Adding to this tragic narrative are the heart-wrenching emails from bereaved parents who stood helplessly by, watching their young children succumb to bowel cancer after a diagnosis arrived far too late.
What these individuals share is an urgent quest for answers—a longing to comprehend why this merciless disease, typically diagnosed in older adults, has begun to starkly affect a growing number of young, robust, and otherwise healthy individuals. The statistics tell a compelling story: cases of bowel cancer are escalating at a rate twice as rapid among those under 50 compared to older populations, a troubling trend that stretches beyond the borders of the UK and echoes across the globe.
Dame Deborah James tragically lost her battle with bowel cancer at the age of 40 in 2022. In her final months, she established the Bowelbabe Fund, which now plays a crucial role in financing a significant five-year research initiative led by esteemed professors at King’s College London.
This baffling situation has galvanized us—an esteemed group of scientists specializing in nutrition and disease epidemiology at King’s College London—to take decisive action.
Earlier this year, we revealed our leadership of the UK segment of a groundbreaking £20 million research initiative known as PROSPECT. This ambitious project aims to meticulously analyze data from millions of individuals to uncover the factors propelling the surge in colorectal cancer cases.
It was the announcement of this project that triggered the deluge of emails—confirming that this issue carries immense significance and demands our immediate attention.
Our comprehensive five-year research endeavor is made possible through the financial support of Cancer Research UK and the Bowelbabe Fund, established by the late Dame Deborah James, who passed away from bowel cancer at just 40 years old. Our team will comprise approximately 100 international scientists, all recognized authorities in various fields including genetics, oncology, dietary research, and molecular biology. Central to our inquiries will be the investigation of the microbiome—the vast ecosystem of trillions of bacteria dwelling in our gut—and its potential role in the genesis of colorectal cancer.
Emerging theories suggest that the presence or absence of specific bacterial populations in the microbiome could influence an individual’s likelihood of developing the disease. If validated, this discovery might one day enable medical professionals to assess cancer risk through an analysis of stool samples.
Moreover, we plan to conduct clinical trials to evaluate whether simple dietary modifications could enhance microbiome health and subsequently lower cancer risk. We are also exploring the potential of weight-loss medications such as Ozempic and Wegovy for younger adults as a preventive measure.
Currently, we don’t possess all the answers, but we anticipate having valuable insights within five years. These findings could fundamentally transform our understanding of bowel cancer risks.
Importantly, while the incidence of many cancers has stabilized in recent years, colorectal cancer among younger populations contradicts this trend, showcasing an alarming rise.
For instance, Strictly Come Dancing star Amy Dowden was diagnosed with stage-3 breast cancer at the age of 32 just last year. Recently, actor James Van Der Beek, known for his role in the iconic 90s series Dawson’s Creek, disclosed that he has been diagnosed with bowel cancer at the age of 47.
Over the past three decades, the global incidence of bowel cancer has surged by a staggering 80 percent. Individuals born in 1990, now in their mid-30s, are nearly 2.5 times more likely to develop bowel cancer compared to those born in 1950.
Strictly dancer Amy Dowden bravely shared her stage-3 breast cancer diagnosis at the age of 32 last year.
Among those who reached out, a 45-year-old woman recently diagnosed with bowel cancer revealed that two of her former classmates from school share the same fate.
The lifestyle shifts we’ve experienced over the years have also played a role; our increasingly sedentary existence, coupled with soaring obesity rates—known contributors to various forms of cancer—remains deeply concerning.
Unraveling the precise causes of this surge remains a formidable challenge. Many individuals diagnosed with bowel cancer maintain a healthy weight and adhere to diets that are generally considered nutritious. To truly comprehend the underlying factors, we need to scrutinize the lives of millions of people, identifying commonalities among those who face early cancer diagnoses.
Fortunately, we have access to expansive studies that will aid our investigation. Our own Zoe database originated from the Covid Symptom Study app, initially designed to monitor virus spread.
This comprehensive database boasts microbiome data from our participants, making it the largest of its kind worldwide. Currently, it has enlisted 200,000 individuals as part of a specialized arm called ZOEPREDICT, which collects substantial information on dietary habits and lifestyle choices.
Professor Tim Spector, a leading figure at King’s College London, is renowned for his work with the Zoe nutrition app.
In addition, the Nurses’ Health Study has amassed critical data on 280,000 participants since its inception in 1976.
Our research will explore which foods may either contribute to or prevent bowel cancer development. Among older individuals, the consumption of processed meats has been identified as a risk factor—equivalent to eating three slices of ham daily, which increases cancer risk by 32 percent. However, younger populations may face different risk factors, especially related to ultra-processed foods laden with numerous chemical additives.
While no particular food is inherently ‘bad,’ we will also evaluate dosage to determine potentially harmful levels of consumption. There exists persuasive evidence, for instance, showing that individuals consuming two sugary drinks per day are twice as likely to develop bowel cancer compared to those who indulge once a week.
Excitingly, another avenue of research is the potential role of anti-obesity medications. These drugs function by mimicking the body’s ‘hunger hormone,’ GLP-1, and tricking the brain into believing the stomach is satiated.
Why twins’ microbiomes can help
A critical area we aim to investigate further is the influence of the gut microbiome—the population of approximately 100 trillion bacteria, viruses, fungi, and other microbes that facilitate digestion and are integral to immune function.
Every individual possesses a distinct microbiome, with its diversity significantly influenced by dietary habits and lifestyle choices. Research has demonstrated that the microbiome plays a vital role in the prevention or onset of various diseases, including type-2 diabetes and cardiovascular issues.
Furthermore, it significantly impacts bowel cancer. We hypothesize that specific bacterial species may present more considerable risks than others. At King’s College London, we are organizing a trial involving 50 pairs of identical twins sourced from the Twin UK Registry—a comprehensive database housing over 15,000 twin pairs established by Professor Spector in 1992 to explore disease development.
During this trial, one twin from each pair will be assigned a customized dietary regimen, while the other continues with their normal eating habits. Throughout the study, we will closely monitor their microbiomes to ascertain whether a personalized diet can effectively diminish the presence of harmful, potentially carcinogenic bacteria. Utilizing twins allows us to eliminate genetic variables from our analysis.
We envision that one day, stool samples could serve as valuable predictive tools to identify those most at risk for bowel cancer, even before symptoms emerge.
Extant research indicates that obesity is a known catalyst for colorectal cancer. Furthermore, preliminary evidence suggests that these medications may uniquely influence cancer risk by reducing inflammation and enhancing metabolic function while also altering microbiome composition. A clinical trial involving 40 participants, led by Harvard gastroenterologist Professor Andrew Chan—one of our partners—aims to explore this connection further.
All trial participants will possess an elevated cancer risk due to previous polyp removals—small growths in the colon that can develop into cancer in about five to ten percent of cases.
Equally crucial, candidates must qualify for weight-loss medications as they are either obese or suffering from type-2 diabetes. Participants will be randomized to receive either the weight-loss medications or standard weight-loss guidance, followed subsequently by monitoring the emergence of cancerous cells.
We still have much to learn about whether young people identified as at-risk for early-onset colorectal cancer could be prescribed drugs like Ozempic in the future.
Recently, it was reported that a woman had died after taking a similar weight-loss medication, Mounjaro—the first confirmed UK death associated with these drugs. This underscores that while these medications may offer potential, they are unlikely to be a magic solution, unable to counteract the broader issue at hand.
Evolving data suggests that the risk factors are intensifying with each generation, emphasizing the urgency of prompt action.
Our ultimate hope is not only to slow this upward trend but to reverse it entirely and provide much-needed clarity to those impacted by this devastating disease.
Shelby was hit by bowel cancer at 24… what could have caused it in such a young and healthy woman?
Shelby Preston was only 24 years old when she received the shocking diagnosis of bowel cancer in July 2022.
Throughout her late teens, she consulted her GP multiple times regarding her distressing symptoms that included abdominal pain, spasms, and alarming episodes of blood in her stool.
Despite maintaining a slim and healthy appearance, she experienced noticeable weight loss, eventually plummeting to a mere six and a half stone, even while consuming a normal diet.
Shelby Preston was just 24 when she was diagnosed with bowel cancer. Now, she serves as an ambassador for charity Bowel Cancer UK.
Initially, medical professionals dismissed her complaints, attributing her symptoms to benign causes, and she was only referred for further testing after vehemently advocating for herself due to the significant blood loss she was experiencing.
To their astonishment, the tests revealed a bowel tumor, which was successfully removed in November 2022. Thankfully, it was detected at an early stage, meaning she could avoid chemotherapy and radiation treatment, although she did require a temporary stoma.
“The whole ordeal was incredibly stressful, and the medical team seemed shocked it turned out to be cancer,” reflects Shelby, now an ambassador for Bowel Cancer UK, hailing from Preston. “I am a testament to the fact that doctors should never disregard these symptoms in young individuals. Had I believed their initial reassurances that my issues were likely minor, the consequences could have been dire.”
“The ramifications of bowel cancer are profound for younger patients—I found it necessary to freeze my eggs prior to surgery, to mitigate potential impacts on my fertility in case chemotherapy was required. There was also the looming possibility of living with a permanent stoma. I carry the weight of worry that my cancer could return,” she adds.
“I have no family history of bowel cancer. I was fit and healthy; I walked frequently and maintained a relatively nutritious diet. It underscores the critical need for scientific inquiry into the forces driving cases like mine.”
She was diagnosed with bowel cancer in July 2022, highlighting the concerning trend of younger individuals facing this devastating disease.
Despite her attempts to seek help, Shelby’s symptoms were often dismissed, reflecting a broader issue within the healthcare system regarding how bowel cancer is perceived in younger populations. Many people, including healthcare professionals, may associate this disease primarily with older adults, leading to potential delays in diagnosis for younger individuals who exhibit warning signs.
Shelby’s experience underscores the need for increased awareness and proactive screening, especially considering the alarming rise in colorectal cancer among younger demographics. The lifestyle and dietary changes over the decades, coupled with a lack of understanding about the unique risk factors affecting younger generations, suggest that more research is required to identify the key contributors to this trend.
In addressing her diagnosis and the factors that may have influenced it, the role of the gut microbiome is particularly pertinent. Environmental factors, diet, and genetic predispositions all play significant roles in shaping a person’s microbiome, which in turn can impact cancer risk. Shelby’s case may reflect a complex interplay of these elements, warranting further investigation into how seemingly healthy individuals can develop bowel cancer at such a young age.
The upcoming studies and trials aimed at understanding the microbiome’s influence on colorectal cancer are crucial. By leveraging comprehensive health databases and conducting clinical trials, researchers hope to uncover the unique factors that contribute to early-onset bowel cancer, ultimately leading to improved prevention and detection strategies. As the scientific community delves deeper into these investigations, the hope is to clarify the causes of this troubling rise and offer targeted interventions that could save lives.
