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Could Childhood E. coli Infections Increase Risk of Colorectal Cancer in Younger Adults?

A colorectal cancer epidemic among young adults may have a common source. One that is decades in the making. Scientists have pinpointed a type of bacterial toxin known as colibactin as the culprit.

This was the subject of a University of California San Diego research study.

What is Colorectal Cancer and How Common Is It?

The American Cancer Society explains that, excluding the various types of skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women.

The group expects around 107,320 new cases of colon cancer and 46,950 new cases of rectal cancer this year.

Men have a 1 in 24 chance of developing colorectal cancer. Women’s odds are 1 in 26.

Despite the decline in diagnosis rates year by year since 2012, a surprising statistic emerged.

For part of the population, those younger than 50 years of age, rates actually increased. In fact, between 2012 and 2021, colorectal cancer diagnosis in those under 50 have increased an average of 2.4% each year. Overall, it is the second most common cause of cancer deaths. The American Cancer Society estimates a significant 52,900 deaths attributed to colorectal cancer in 2025.

Significant cause for concern.

Once considered an elderly disease, this cancer is trending in at least 27 countries to be the leading cause of cancer-related death among young adults by the year 2030.

But why is this happening?

Scientists Found a Connection in Early-Onset Colorectal Cancer Diagnosis

The study, published in Nature looked at 981 colorectal cancer genomes. Patients included those with both early- and late-onset disease.

There was a pattern.

A certain DNA mutation was 3.3 times more common in early-onset cases. More specifically, cases in those under 40 years of age versus those diagnosed after 70.

Of the 11 countries these samples originated from, those with higher incidence of early-onset, the mutation appeared more prominently.

“These mutation patterns are a kind of historical record in the genome, and they point to early-life exposure to colibactin as a driving force behind early-onset disease,” said study senior author Ludmil Alexandrov, professor in the Shu Chien-Gene lay Department of Bioengineering and the Department of Cellular and Molecular Medicine at UC San Diego.

Colibactin has been a focus of Alexandrov’s previous research. Research also focusing on colorectal cancer and late-onset diagnosis.

What is colibactin, and what influence does it have on this type of cancer?

What is Colibactin?

Colibactin is a type of toxin produced by certain strains of Escherichia coli bacteria. While Shiga toxin gets most of the press, colibactin is also a serious concern.

When those E. coli bacteria inhabit the colon and rectum produce colibactin toxin, the toxin can make changes to cell DNA in that region.

This is because the toxin is capable of altering DNA. Leaving mutations behind that provide a distinct genetic signature on the DNA of colon cells. “One that may increase the risk of developing colorectal cancer before the age of 50.”

The earlier the body is exposed to this toxin, the longer the genetic mutation has to spread and cause cancerous disease.

Molecular Timing Is Everything

These scientists are able, to an extent, uncover a timeline of mutational signals that help determine when the damage occurred.

In cases where the molecular damage occurred within the first 10 years of life, early-onset colorectal cancer occurrence was significant.

A finding consistent with the discovery that colibactin-related mutations account for around 15% of mutation drivers.

“If someone acquires one of these driver mutations by the time they’re 10 years old,” Alexandrov explained, “they could be decades ahead of schedule for developing colorectal cancer, getting it at age 40 instead of 60.”

Making preventative measures for E. coli infection more important than ever.

Preventing E. coli Infection

Protecting children from E. coli infection is important for so many reasons.

First, no one wants their child to experience E. coli symptoms. Additionally, children are not only more vulnerable to infection if exposed. They are more susceptible to certain complications like hemolytic uremic syndrome (HUS) that can be life-threatening.

Certain key behaviors and precautions can go a long way in preventing E. coli infections. Especially in young children.

Hand Washing

Handwashing and clean hands are the best ways to prevent E. coli infection. Not only does it help protect yourself, but it also helps prevent spreading illness to others.

Help your child build strong hand washing skills. Teach them when to wash their hands.

  • After using the bathroom or helping someone else in the bathroom (or changing a diaper)
  • Before and after cooking or eating
  • After handling raw meat
  • After touching livestock or anything in their habitat.
  • Any time you believe your hands may be dirty or contaminated

Helping children in these habits helps protect them and others from E. coli and other foodborne illnesses.

Avoid Unpasteurized Dairy and Juice

Pasteurization is a heat treatment process proven to kill harmful bacteria, viruses, and other pathogens potentially lurking in the food or drink. While unpasteurized dairy and juice are growing in popularity, consuming them leaves you and your child at risk of E. coli or other foodborne germs like Salmonella or Listeria.

Basic Food Safety

The Centers for Disease Control and Prevention (CDC) explains that basic food safety comes down to four major steps. Clean, separate, cook, and chill.

Clean

Keep your hands and food contact surfaces clean. Never reuse utensils, plates, or cutting boards that have been used for raw meats. Be sure to wash them before using them for cooked or ready-to-eat food.

Separate

Keep raw meat away from cooked or ready-to-eat food. This starts when grocery shopping in the shopping cart and continues through transportation and storage in your kitchen at home. Place meat in a leak-proof container on a lower shelf to prevent juices from contaminating other food in the refrigerator.

Cook

Cook all foods to the recommended safe minimum internal temperature. Use a food thermometer for accurate measurement.

Chill

Refrigerate leftovers immediately. Hot food should be kept hot, and cold food should be kept cold. If temperatures enter the “danger zone,” a range from 40° F to 140° F, a two-hour clock starts. One hour, if ambient temperature is above 90° F.

During this range, germs grow rapidly to infectious quantities.

Quickly cool food in shallow containers or discard it.

How Serious is This Link?

While Alexandrov cautioned that while there is strong support for this hypothesis, more research is needed.

However, I think we can all agree that regardless of the tragic link to colorectal cancer, preventing E. coli infection in people of all ages is a worthy endeavor.

Stay in Touch with Make Food Safe!

If you’d like to know more about food safety topics in the news, like “Could Childhood E. coli Infections Increase Risk of Colorectal Cancer in Younger Adults?,” check out the Make Food Safe Blog. We regularly update trending topics, foodborne infections in the news, recalls, and more! Stay tuned for quality information to help keep your family safe, while The Lange Law Firm, PLLC strives to Make Food Safe!

By: Heather Van Tassell (contributing writer, non-lawyer)

Heather Van Tassell

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