Colorectal Cancer ACS Research Highlights

The American Cancer Society helps find answers to critical questions about
colorectal cancer (CRC). What causes it? How can it be successfully prevented, detected,
and treated? What is the best age to start screening? How can the quality of life for colorectal cancer survivors be improved?

Studying questions like these has helped improve screening and treatment methods,
which has contributed to substantial decreases in deaths from colorectal cancer
over the past 20 years. 

Spotlight on ACS Research Publications

The American Cancer Society (ACS) employs a staff of full-time researchers and funds scientists across the United States who relentlessly search for  answers to help us better understand cancer, including colorectal cancer. Here are some highlights of their work.

Taming “Gemini” Immune Cells—Tumor-Infiltrating Neutrophils

Researcher’s discovery of how tumor-infiltrating neutrophils may abet or kill colorectal cancers based on tumor grade uncovers two promising treatments.

“Neutrophils are well known for their role in defending the body against invading pathogens. In my lab, we found that neutrophils play important roles in the transformation of healthy cells to cancer cells. When there is inflammation, neutrophils migrate into inflamed tissues, where they increase the occurrence of DNA mutations. They also slow the cell’s ability to repair itself, which ultimately increases the chance of developing cancer. Colorectal cancer is just one type of cancer associated with a high number of neutrophils within and around tumors.

As we continued to study the function of neutrophils in cancer, we learned that neutrophils can function as a double-edge sword. That is, they kill cancer cells under some circumstances, while under other circumstances, they help cancer evolve and grow. Thus, neutrophils are very attractive new targets for new or improved therapeutic approaches to battle cancer.

“In this study, we demonstrate that neutrophils migrating into developing colon tumors can shape the way cancer cells repair broken DNA. By doing so, neutrophils affect progression of colorectal cancer and its response to commonly used treatments known as DNA-repair targeted therapy.”—Ronen Sumagin, PhD

See the highlight about Dr. Sumagin's published study.


Insurance Links Cancer Screening Rates with Unemployment

ACS researchers reveal the need to protect cancer screening rates when unemployment is high, as it has been during the COVID-19 pandemic.

“We found that health insurance coverage fully accounted for fewer cancer screenings among unemployed adults in the United States. That discovery is particularly noteworthy because it’s potentially modifiable. The US could ease some economic distress from the COVID-19 pandemic by developing and approving comprehensive health policies that ensure health insurance coverage and access to preventive care while people are unemployed. Such policies are required to protect cancer screening for future economic downturns too.

“A finding from another study that policy makers may find worth considering for the future is that increases in unemployment only increased cancer death rates in countries that don’t have universal health coverage. Universal health coverage seems to erase the links between employment and cancer screening rates as well as between employment and cancer death rates.—Stacey Fedewa, MPH, PhD

Read the highlight about Dr. Fedewa’s published study.


New Epigenetic Target May Lead to Personalized Treatments

How a researcher unraveled DNA from a histone spool and found the gene that enhances a cell to become colorectal cancer

“My lab focuses on understanding the contribution of the physical structure of DNA—called the epigenome—to the progression of cancer and on identifying new venues for therapy and diagnostic tools.

“Abnormal structures in the epigenome—called epimutations—have emerged to be a key feature associated with cancer progression. And although researchers hypothesize that these events could be exploited for personalized medicine, how to do that is not yet well understood.

“My lab has recently shown that the epigenome content of tumors can be analyzed and used to stratify patients into groups based on epigenomic subtypes, identifying who will respond to specific targeted therapies for colorectal cancers.”—Kunal Rai, PhD

See the highlight about Dr. Rai's published study.


Country Clinic Cousins Share Winning Screening Strategies

ACS research grantee chats with rural clinics to discover innovative ways they’ve drawn people in for screening to spread the word with other rural clinics.  

“One of the rural clinics we talked to said that one of their approaches was to send out the [colorectal cancer screening] information in a format where it actually looked like . . . an auction for cattle and for animals in a way that would grab the farmer’s attention . . . in the mail as opposed to a regular flyer from your doctor’s office.

“I think the lower-performing rural clinics will be more easily able to adapt and implement the interventions from higher-performing rural clinics than taking interventions from large academic health centers.”—Jennifer Weiss, MD, MS

Listen to the podcast.


Food Combos May Help Reduce the Risk of Colorectal Cancer

Nutritional epidemiologist identifies how combinations of foods and drinks influence biological markers known to cause cancer.

“My approach to the nutrition that causes cancer is based on identifying combinations of foods and beverages that influence biological markers known to cause cancer. And one of these biological markers is insulin. Insulin is a very useful chemical in our bodies that helps to lower our blood sugar level and prevent us from developing diabetes. However, if levels of insulin are constantly high, our bodies may develop insulin resistance, [which is] when our body cells are not able to respond to insulin and [not able to] use glucose for energy. Insulin resistance increases the risk of obesity and Type 2 diabetes, which are strong risk factors for developing colorectal cancer.

“. . .  for lowering sustained high insulin levels, maximizing green-leafed vegetables versus other vegetables is optimal. Also, a tomato-based salad, when consumed with a source of fat such as avocado, nuts, olive oil, or cheese, can have more influence lowering levels of insulin than simply consuming fresh tomatoes.”—Fred Tabung, PhD, MSPH

Listen to the podcast: Changing dietary patterns to impact colorectal cancer risk across the globe.


Survival Rates for CRC Remain Low in Sub-Saharan Africa

Researchers find a country’s Human Development Index (HDI) affects colorectal cancer (CRC) outcomes even more than stage at diagnosis.

“We randomly selected 1,707 people with colorectal cancer between 2005 and 2015 from 13 population-based cancer registries in sub-Saharan Africa. We found that survival for colorectal cancer remains low in sub-Saharan African countries, though estimates vary considerably by Human Development Index (HDI). People living in a low-HDI country had twice the risk of death than those in a high-HDI country, even when colorectal cancer was diagnosed at an early stage.”—Ahmedin Jemal, DVM, PhD

See the highlight of Dr. Jemal's published study.


Extramural Discovery Grants in Colon and Rectal Cancer

The American Cancer Society funds scientists who conduct research about cancer at medical schools, universities, research institutes, and hospitals throughout the United States. We use a rigorous and independent peer review process to select the most innovative research projects proposals to fund. 

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Total Colorectal Cancer Grants in Effect as of August 1, 2021

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Total Colorectal Cancer Grants in Effect as of August 1, 2021

ACS Cancer Prevention Studies

Focus on Early-Onset Colorectal Cancer

One aim of ACS Population Science (PopSci) researchers leading Cancer Prevention Study-3 (CPS-3) and Cancer Prevention Study-II (CPS-II) is to learn more about the risks of developing colorectal cancer (CRC) and how to prevent it.

They're particularly interested in better understanding factors that may be contributing to the increasing incidence of early-onset CRC, which is diagnosed before a person is age 50. In fact, ACS PopSci researchers recently created a large consortium study focused on exploring risk factors for early onset CRC. This work has been highlighted in several medical journals.

In addition, the CPS-II and CPS-3 biospecimen management team continues to build a tumor repository, including a collection of CRC tumor samples. Access to these samples supports large collaborations who are studying the link between lifestyle and behavioral factors with specific molecular changes in such tumors.

The CPS-3 Gut Microbiome Sub-Study will also allow PopSci researchers to investigate how the gut microbiome may be related to lifestyle and environmental risk factors of CRC and early-onset CRC.

Podcast: Investigating the Rise of Early-Onset Colorectal Cancer

Listen to this podcast about the trouble increase in early-onset colorectal cancer (CRC) with the former ACS Scientific Director in the Population Science department, Peter Campbell, PhD. As one of the leading researchers in this space, Campbell's work along with the work of other ACS researchers, helped lead to the ACS recommendation to begin CRC screening at age 45 for people at average risk.

Colorectal Cancer Facts & Figures in Brief

Overall Death Rates for Colorectal Cancer Are Down 

Each year, the American Cancer Society department of Surveillance and Health Equity Science analyzes data on colon and rectal cancers as part of Cancer Facts & Figures. Every 3 years, with support from their research teams, ACS epidemiologists Rebecca Siegel, MPH, and Ahmedin Jemal, DVM, PhD, publish Colorectal Cancer Facts & Figures and an accompanying article, Colorectal Cancer Statistics.

These publications provide statistics about colon and rectal cancers in the United States. They also cover the latest information on risk factors, early detection, treatment, and current research.

Here are some key facts and statistics about colon and rectal cancers from these publications.

  • In 2022 in the US, an estimated 106,180 people will be diagnosed with colon cancer. About 44,850 will be diagnosed with rectal cancer.
  • Incidence rates are decreasing in adults age 50 and older, mostly due to increased screening. However, incidence rates are increasing among those younger than age 50 for unknown reasons.
  • People who identify as American Indian or Alaska Native (AIAN) have the highest incidence rates for colorectal cancer. During 2014 to 2018, their rates were about 40% higher than those in White people. In 2022, about 52,580 people will die from colorectal cancer. Deaths for colon and rectal cancers are combined because a large number of deaths from rectal cancer are misclassified as colon cancer. That's partly because of the cultural reluctance to use the term rectum in educational messaging.
  • Colorectal cancer death rates are highest in people who are Black. During 2015 to 2019, death rates were almost 40% higher than rates in White people. However, these data are based on information in death certificates, which is known to be missing accurate information on race for 1-in-3 people who are American Indian or Alaska Native. This means that all death rates for American Indian and Alaska Native people are underestimated by approximately 30%, which would mean that colorectal cancer mortality rates are probably highest in this population. 
  • More than half (55%) of colorectal cancers in the US are attributable to these potentially modifiable risk factors:

Find more statistics about colorectal cancer on the Cancer Statistics Center:

  • Estimated new cases and deaths by state
  • Historical trends in incidence rates 
  • Historical trends in death rates 
  • 5-year survival rates 

Use the analysis tool in the drop-down menu to see any of these statistics in comparison to other types of cancer.