Early indicators of bowel cancer

Colorectal cancer (CRC) is a major health problem in Denmark, especially among the elderly. People with inflammatory bowel disease (IBD) – such as ulcerative colitis or Crohn’s disease – have a much higher risk of developing a specific type of cancer called colitis-associated colorectal cancer (CAC), which is driven by long-term inflammation in the gut. At present most IBD patients follow the same screening programme for cancer, even though the individual risk may vary considerably. This means that some patients may be over-monitored, while others are under-protected.

“This project, which is supported by the Vissing Foundation, aims to find biomarkers that can predict which IBD patients have the greatest risk of developing cancer. We are using a large collection of retrospective FFPE tissue samples (formalin-fixed paraffin embedded), which can be stored for many years. The samples are taken from real-life patients – including IBD patients with and without cancer, and patients with regular (sporadic) colorectal cancer. We will search for tiny RNA molecules that can reveal early indications of developing cancer,” explains Jaslin Pallikkunnath James at the Herlev Hospital Department of Pathology.

RNA molecules function as messengers in cells. They show which genes are active, and control how proteins are formed. Changes in small RNA molecules can therefore reveal early indications of cancer.

“This is one of the first studies that directly compares inflammation-driven and non-inflammatory colorectal cancers at the molecular level. If we can understand why some patients develop cancer, while others do not, we hope we can pave the way for more precise and efficient screening strategies, and consequently better use of health resources and improved results from treatment,” says Jaslin Pallikkunnath James.