Colorectal Cancer - Fred Hutchinson Cancer Research Center

Diseases / Research

Colorectal Cancer

Colon cancer cells

Mucin lakes are stained blue in the colon carcinoma (top). Mucin is normally made by the goblet cells in the normal colon tissue (bottom)

Photo by Fred Hutch Experimental Histopathology

Click for high-res version

Fred Hutch researchers are pursuing discoveries that could revolutionize how we prevent, detect and treat colorectal cancer.

A number of prevention studies are focused on identifying key lifestyle factors that may affect a person's risk.  Researchers are investigating ways to detect colon cancer early by improving screening tests.  Another goal is to develop more personalize care for people diagnosed with colon cancer.  Fred Hutch is leading one of the first studies looking at the various factors that can determine a person's treatment outcome.

Fast Facts

  • Colorectal cancer ranks as the third most commonly diagnosed—and second-deadliest—form of cancer in the United States in men and women.

  • Colorectal cancer affects major organs of the digestive system: the colon and/or rectum, which together form a muscular tube about 3 feet long.

  • Colorectal cancer develops in the digestive tract, often from growths, called polyps, which are benign initially but transform into cancerous tumors. Those cancer cells invade and destroy nearby tissue, and can break away from the original tumor to form new tumors in other parts of the body through a process called metastasis.

  • Colorectal cancer is preventable and can be successfully treated if detected early. It typically strikes people over age 50 -- it's recommended that people start screening at that age. Some healthcare experts suggest African-Americans begin screening at 45.

  • People who have a strong family history of the disease should consider an appointment at Seattle Cancer Care Alliance's gastrointestinal cancer prevention center.

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Prevention & Causes

Fred Hutch researchers are identifying key factors that affect a person's colorectal cancer risk:

Laxatives and cancer risk — A study of 75,000 adults found that frequent use of fiber-based laxatives is associated with a decreased risk of colorectal cancer while the use of non-fiber laxatives is linked to significantly increased risk of the disease. Learn more >

Obesity and cancer risk – Hutch researchers are unraveling how obesity influences cancer risk and defining strategies to reduce it. Dr. Mario Kratz is conducting some of the world’s most innovative studies on how improving a person’s eating habits might break that link. His work could ultimately redefine the guidelines that tell us what we should eat, and could help people know exactly which foods elevate their cancer risk.  Learn more >

Genetics and environmental factors – Fred Hutch is home to the Seattle Familial Colorectal Cancer Registry, which investigates how genetic and environmental factors contribute to colorectal cancer. Learn more >

Gene variants - The coordinating center, co-led by Drs. Ulrike Peters and Li Hsu, for the international consortium is based at Fred Hutch. Researchers from North America, Australia and Europe are working to discover the cancer-related gene variants that play a role in risk for colorectal cancer. Learn more >

Aspirin – Aspirin and other nonsteroidal anti-inflammatory drugs, or NSAIDs, may reduce the risk of colorectal cancer by up to half. Because those drugs can have negative side effects, Dr. Neli Ulrich is investigating whether NSAIDs do more harm than good. Learn more >

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Detection & Diagnosis

Fred Hutch researchers are investigating new tests that could dramatically improve colorectal cancer screening:

Early detection of colon cancer -  Dr. Paul Lampe’s laboratory specializes in finding cancer-specific signatures in blood samples to serve as diagnostic biomarkers for detecting disease. While the lab is interested in finding biomarker panels for multiple cancers, Dr. Jon Ladd is focusing on early detection of colorectal cancer and recently published results in Gut this month. Learn more >

Improving early detection – Dr. William Grady is working to identify the earliest detectable changes in normal colon cells that become cancerous. Through those findings, he hopes to develop a safe and accurate colorectal cancer test that analyzes blood or stool samples. The goal is to encourage more people to get screened for colorectal cancer and use the more-invasive colonoscopy procedure for higher-risk cases. Grady is also studying how mutations in certain genes cause colorectal cancer to grow, which could lead to new treatments. Learn more >

Insights into colon polyps and cancer - Dr. Yanxin Luo and colleagues in the laboratory of Dr. William Grady conducted a genome-wide analysis of DNA methylation changes in colon tissues, adenomas and cancer samples to identify three subtypes of colorectal cancers. They identified unique polyp subgroups that may be the precursors for specific molecular subtypes of colorectal cancer. Learn more >

Routine tests and health care costs —Dr. Scott Ramsey has found that colorectal cancer patients diagnosed through a routine test to detect blood in the stool have less advanced disease and significantly lower health care costs than those diagnosed because of symptoms. Learn more >  

Using biomarkers for early detection — Dr. Ziding Feng and Dr. Mark Thornquist lead the Early Detection Research Network, which aims to determine how biomarkers might help assess a person's cancer risk and catch cancers earlier.

Testing for subtypes of colorectal cancer — Dr. Polly Newcomb is leading a team to study serrated colorectal cancer, an aggressive subtype of colorectal cancer, to look at the distribution of genetic variants compared to other forms of colorectal cancer and the screening history and clinical factors.  Learn more >

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Treatment & Prognosis

Interplay between molecular markers and tumor subtypes and survival outcomes - Drs. Amanda Phipps and Polly Newcomb combined four molecular tumor markers to evaluate five different colorectal cancer subtypes, and found marked differences in survival.  Learn more >

Pursuing customized treatments – Dr. Neli Ulrich is leading the first study that takes an in-depth look at the various factors that can determine the outcome of a colorectal cancer diagnosis. In the ColoCare Consortium study, researchers hope to learn what patients themselves can do to improve their health after diagnosis and to develop customized treatments to fit individual patients' bodies.

Health outcomes for chemotherapy patients — Underuse of supportive-care drugs known as colony-stimulating factor use can result in serious adverse health outcomes for chemotherapy patients that range from life-threatening infections to interruption of chemotherapy to reduced chemotherapy dose intensity. Hutchinson Institute for Cancer Outcomes Research (HICOR) is leading a clinical trial evaluating the use of colony stimulating factor to reduce the risk of serious infection in patients undergoing chemotherapy for breast, colorectal or lung cancer. The study is a partnership with SWOG, Columbia University and the UW School of Pharmacy, and will investigate whether a health-systems-based intervention can improve adherence to evidence-based guidelines for the use colony-stimulating factor. Learn more

Risk of second cancer — Fred Hutch's Dr. Amanda Phipps along with colleagues from Massachusetts General Hospital and the Harvard School of Public Health, used Surveillance Epidemiology and End Results (SEER) cancer registries to estimate the risk of a second primary cancer, by cancer site, in CRC survivors, compared to the risk of cancer in the general population. Learn more >

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