Colorectal Cancer
Colorectal cancer is one of the most commonly diagnosed cancers in the United States — and the second most common cause of cancer deaths among men and women combined. About 100,000 cases of colon cancer, and just under 45,000 cases of rectal cancer, are diagnosed per year.
These cancers develop in the large intestine (colon and rectum), often from growths called polyps. Polyps are found in a third of all people. Initially benign, these growths may transform into cancer. In some cases, these cancers can become advanced or metastatic, breaking away from the large intestine to form new tumors elsewhere in the body. Although it is a very serious disease, colorectal cancer is preventable and can be successfully treated if detected early.
Colorectal Cancer Research
Fred Hutch researchers are seeking better ways to prevent and detect colon polyps and colon cancer, and better ways to treat colorectal cancer. We are also working toward improved understanding of the factors that influence each person’s risk of developing this cancer. Our scientists are also developing new methods to gauge the likelihood a tumor will respond to treatment.
Our physician-researchers are running numerous clinical trials of new drugs and drug combinations to treat different types of colorectal cancer. These experimental therapies are part of a trend toward precision cancer care, in which treatments are designed to target a specific patient’s tumor based on its molecular profile.
Much of our research is focused on developing more precise ways to prevent colon cancer through early detection and prompt, personalized treatment. Because colonoscopy procedures can detect and remove precancerous polyps, screening and prevention for this disease are tightly linked. Our researchers also study factors that can boost colorectal cancer survival in certain patients, such as exercise or the use of NSAIDs such as aspirin.
Prevention and Early Detection
Fred Hutch is home to several large-scale studies focused on identifying the key lifestyle factors that may affect a person’s risk of colorectal cancer. We are also investigating ways to detect colon cancer earlier with improved tests that can identify people with polyps or with early cancer. Much of our research is focused on identifying biomarkers such as genes or proteins associated with higher risk. Having such biomarkers or a family history of colon cancer would warrant more intensive and frequent screening.
Our epidemiologists are working alongside our bench scientists to integrate genetic, lifestyle and environmental risk factors into a single comprehensive predictor of colorectal cancer risk. This precision prevention tool could eventually provide a better guide for personalized dietary recommendations and interventions such as the use of aspirin to reduce risk. It could also tell doctors when to recommend colonoscopy screening for each patient.
New Drug Targets
Our scientists are discovering gene mutations that may increase risk of colon cancer and telltale proteins on cancer cells that could be targets for new drugs. This knowledge could improve prevention and early detection efforts as well as treatment.
Clinical Trials
Our colorectal cancer clinical studies typically involve combinations of conventional chemotherapy drugs with new therapeutic agents. Some of these new drugs are immunotherapies, drugs that restore the cancer-killing capacity of immune cells that have been disarmed by the tumor. Other new drugs inhibit particular molecular pathways in cancer cells. Such drugs disrupt the inner workings of tumor cells that have been dangerously altered by gene mutations.
Prevention and Early Detection
New Drug Targets
Precision Prevention
Prevention and Early Detection
Fred Hutch is home to several large-scale studies focused on identifying the key lifestyle factors that may affect a person’s risk of colorectal cancer. We are also investigating ways to detect colon cancer earlier with improved tests that can identify people with polyps or with early cancer. Much of our research is focused on identifying biomarkers such as genes or proteins associated with higher risk. Having such biomarkers or a family history of colon cancer would warrant more intensive and frequent screening.
Current Projects
APPEAL: Exercise intervention in colorectal polyp patients
Public Health Sciences, EpidemiologyScientists are investigating the efficacy of a moderate exercise program on colon cancer and how exercise may lower risk in humans.
Funding Agency: National Cancer Institute
Contact: Anne McTiernan, amctiern@fredhutch.org
Advanced Colorectal Cancer of Serrated Subtype (ACCESS) Study
Public Health Sciences, Cancer PreventionResearchers are studying a subtype of colorectal cancer (CRC) that develops via the serrated pathway with a goal of determining future prevention strategies and advancing treatment for CRC.
Funding Agency: National Institutes of Health
Contact: Rachel Malen, rmalen@fredhutch.org
Bacterial Correlates of Colorectal Cancer Subtypes and Survival
Public Health Sciences, EpidemiologyScientists identify differences in the gut bacterial community in patients with etiologically-distinct subgroups of colorectal cancer, and how those differences relate to survival.
Funding Agency: National Cancer Institute
Contact: Amanda Phipps, aphipps@fredhutch.org
Colorectal Research in Epidemiology (CORE) Family Studies
Public Health Sciences, Cancer PreventionWorking with biological specimens, medical records and interviews, researchers investigate how genetic, environmental and lifestyle factors effects the incidence of colon and rectal cancers.
Funding Agency: National Institutes of Health
Contact: Rachel Malen, rmalen@fredhuthc.org
Exercise Effects in Men & Women on Colon DNA Methylation
Public Health Sciences, EpidemiologyThis project will investigate the effects of physical activity on colon DNA methylation in genes related to colon cancer. Excessive DNA methylation is thought to be a risk factor for colon cancer, and no previous study has tested the effect of exercise on DNA methylation in the colon. The project includes 202 initially sedentary men and women who have already completed the trial from which colon samples will be used. In addition, we received supplemental funding for this project will investigate whether vitamin D supplementation modifies the effect of physical activity on risk factors for colorectal cancer including gene expression and activity, proliferation, and cell death. We will investigate these effects in colorectal tissue samples from initially sedentary men and women who have completed a 12-month exercise trial.
Funding Agency: National Cancer Institute
Contact: Anne McTiernan, amctiern@fredhutch.org
Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO)
Public Health Sciences, Cancer PreventionThrough the collaborative effort of researchers from three continents, GECCO researchers study the impact of common and rare genetic variants across the entire genome by performing whole genome sequencing and genotyping. They also align detailed clinical, epidemiologic, and outcome data across the studies in the consortium.
Funding Agency: National Institutes of Health
Contact: Tabitha Harrison, tharriso@fredhutch.org
Lifestyle Factors and Survival Outcomes for Colorectal Cancer Molecular Subtypes
Public Health Sciences, EpidemiologyScientists explore the impact of lifestyle on colorectal cancer survival, including differences based on the molecular subtypes of tumors.
Funding Agency: National Cancer Institute
Contact: Amanda Phipps, aphipps@fredhutch.org
Metabolic Strategies for Discovery and Verification of Novel Biomarkers of Colorectal Cancer Recurrence
- Christopher Li, M.D., M.P.H.
- Cornelia Ulrich
Through a well-defined cohort of newly diagnosed colorectal cancer patients, scientists are identifying blood-based biomarkers that can accurately predict disease recurrence.
Funding Agency: National Cancer Institute
Contact: Kathy Vickers, kvickers@fredhutch.org
PROSPR: Coordinating center for population-based research to optimize cancer screening
Public Health Sciences, EpidemiologyBuilding on the success of PROSPR I, PROSPR II investigators from a variety of disciplines are conducting research based on cervical, colorectal, and lung cancer screening.
Funding Agency: National Cancer Institute
Contact: Marty Stiller, mstiller@fredhutch.org
Prospective Study of Selenium, Genetics of Selenoenzymes and Colorectal Cancer
Public Health Sciences, Cancer PreventionResearchers assess the role of selenium on colorectal cancer in a large cohort of women. Selenium is a critical component of a number of selenoenzymes that have antioxidative and anti-inflammatory properties, and thus may be important in preventing colorectal cancer.
Funding Agency: National Institutes of Health
Contact: Tabitha Harrison, tharriso@fredhutch.org
Selenium, Genetic Variation in Selenoenzymes in Prostate Cancer
Public Health Sciences, Cancer PreventionScientists explore the molecular and genetic pathways underlying selenium as a chemopreventive agent for prostate cancer. Selenium is essential for the activity of selenoenzymes, which prevent oxidative damage to DNA and other biomolecules. And because selenoenzymes may control inflammation and immune response, they may help prevention of prostate cancer.
Funding Agency: National Institutes of Health
Contact: Tabitha Harrison, tharriso@fredhutch.org
TrACER study page
Training and Research in Colon Cancer Survival
Public Health Sciences, Cancer PreventionThis is an Established Investigator award for training and research in colorectal cancer survivorship. Researchers focus on the epidemiology of cancer survival while fostering mentoring relationships with newly-graduated scientists.
Funding Agency: National Institutes of Health
Contact: Rachel Malen, rmalen@fredhuthc.org
Transdisciplinary Team Science in Colorectal Cancer Prognosis
Public Health Sciences, EpidemiologyResearchers are expanding the current ColoCare Study, opening two sites focused on the recruitment of ethnic/racial minorities and performing molecular characterization of tumor samples.
Funding Agency: National Cancer Institute
Contact: Kathy Vickers, kvickers@fredhutch.org
Vitamins and Lifestyle (VITAL) Study
- Emily White, Ph.D.
The VITAL study investigates the associations of supplement use with cancer risk. Investigators are specifically concerned with how vitamin C, E, calcium, multivitamins, folate, omega-3 fatty acids, and fiber related to prostate, breast, lung, colorectal, melanoma, bladder, blood/lymph cancers, as well as total cancer incidence and total mortality.
Funding Agency: National Institutes of Health
Contact: Emily White, ewhite@fredhutch.org
Current Projects
Current colorectal cancer research projects at Fred Hutch include the following:
APPEAL: Exercise intervention in colorectal polyp patients
Public Health Sciences, EpidemiologyScientists are investigating the efficacy of a moderate exercise program on colon cancer and how exercise may lower risk in humans.
Funding Agency: National Cancer Institute
Contact: Anne McTiernan, amctiern@fredhutch.org
Acute Effects of Exercise on Breast Cancer Biomarkers (ACE) Study
Public Health Sciences, EpidemiologyThe Acute Effects of Exercise on Breast Cancer Biomarkers (ACE Study) is enrolling women to test the effect of moderate intensity exercise on cancer risk factors such as biomarkers in healthy women. Knowing if exercise significantly alters these biomarkers, could help support guidelines for daily exercise for breast cancer prevention and could indicate that exercise even without weight loss is beneficial.
Contact: Jude Warner, acestudy@fredhutch.org
Advanced Colorectal Cancer of Serrated Subtype (ACCESS) Study
Public Health Sciences, Cancer PreventionResearchers are studying a subtype of colorectal cancer (CRC) that develops via the serrated pathway with a goal of determining future prevention strategies and advancing treatment for CRC.
Funding Agency: National Institutes of Health
Contact: Rachel Malen, rmalen@fredhutch.org
Advancing our Understanding of the Etiologies and Mutational Landscapes of Basal-like, Luminal A, and Luminal B Breast Cancer
Public Health Sciences, EpidemiologyAddressing research gaps in the molecular subtypes of breast cancer, researchers are taking a multidisciplinary approach to study the epidemiology and mutational landscapes of basal-like, luminal A, and luminal B tumors.
Funding Agency: DOD
Contact: Sarah Taylor, sataylor@fredhutch.org
Ancillary Cost-Effectiveness Analysis
Public Health Sciences, Cancer PreventionResearchers are determining the cost-effectiveness of cord blood vs. haplo matched relatives using clinical information from the Bone Marrow Transplant (BMT) Clinical Trials Network (CTN) and insurance claims data.
Funding Agency: National Institutes of Health
Contact: Jordan Steelquist, jsteelq@fredhutch.org
Bacterial Correlates of Colorectal Cancer Subtypes and Survival
Public Health Sciences, EpidemiologyScientists identify differences in the gut bacterial community in patients with etiologically-distinct subgroups of colorectal cancer, and how those differences relate to survival.
Funding Agency: National Cancer Institute
Contact: Amanda Phipps, aphipps@fredhutch.org
Breast Cancer Initiative 2.5
Public Health Sciences, EpidemiologyBreast Cancer Initiative 2.5 is uniting the global breast cancer community behind a common goal to make breast health a global priority and reduce disparities in breast cancer outcomes for 2.5 million women by 2025.
Breast Health Global Initiative (BHGI)
Public Health Sciences, EpidemiologyThe Breast Health Global Initiative is striving to improve breast health outcomes and access to breast cancer screening, detection and treatment for women in low- and middle-income countries.
Contact: Marisa Hartman, 206.667.3538
Breast, Colorectal and Ovary Cancer Clinical Validation Center
Public Health Sciences, EpidemiologyAfter identifying early detection biomarkers for each of these cancers, scientists have organized phase 2 and phase 3 validation studies for clearly defined clinical applications.
Funding Agency: National Cancer Institute
Contact: Chris Li, cili@fredhutch.org
Cancel Save & Close Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH)
Public Health Sciences, Cancer PreventionThe MsFLASH network conducts clinical trials aimed at finding promising treatments for the most common symptoms of menopause.
Cancer Epidemiology Research Cooperative (CERC)
Public Health Sciences, EpidemiologyThe Cancer Epidemiology Research Cooperative (CERC) conducts research to improve knowledge about the causes of cancer and its impact on the lives of those affected, in order to reduce cancer occurrence and suffering and to improve survival.
Carotene and Retinol Efficacy Trial (CARET)
- Marian Neuhouser, Ph.D. R.D.
- Mark Thornquist, Ph.D.
- Gary Goodman, M.D.
- Charles Kooperberg, Ph.D.
- Noel Weiss, M.D., Dr.P.H.
- Chu Chen, Ph.D.
Researchers tested the efficacy and safety of beta-carotene and retinyl palmitate in people at high risk for lung cancer in a randomized, double-blind, placebo-controlled trial. Active follow-up of trial. participants ended on June of 2005; however, the program continues to support the extensive biological repository and ancillary studies that use CARET samples and data.
Contact: Jackie Dahlgren, jdahlgre@fredhutch.org
Chronic Myelogenous Leukemia Care in the Tyrosine Kinase Era
Public Health Sciences, EpidemiologyUsing the Optum Labs/United Healthcare database, investigators review healthcare use patterns of chronic myelogenous leukemia patients treated in the tyrosine kinase inhibitor era.
Funding Agency: American Association for Cancer Research (AACR)
Contact: Nancy Blythe, nblythe@fredhutch.org
Clinical and Economic Value of Next Generation Sequencing-Based Diagnostic Testing in Cancer Care
Public Health Sciences, Cancer PreventionResearchers are developing a decision model designed to evaluate the cost effectiveness of multiplex NGS testing vs. usual care. They plan to pair the decision model with information theory to identify the most efficient and impactful study designs.
Funding Agency: Personalized Medicine Coalition
Contact: Jordan Steelquist, jsteelq@fredhutch.org
Collaboration for a Healthy Community (Together We STRIDE)
Public Health Sciences, Cancer PreventionThe goal of the project is to build and enhance community capacity and infrastructure on childhood obesity initiatives in the Lower Yakima Valley, Washington.
Funding Agency: National Institute on Minority Health and Health Disparities
Contact: Sonia Bishop, sbishop@fredhutch.org
Colorectal Research in Epidemiology (CORE) Family Studies
Public Health Sciences, Cancer PreventionWorking with biological specimens, medical records and interviews, researchers investigate how genetic, environmental and lifestyle factors effects the incidence of colon and rectal cancers.
Funding Agency: National Institutes of Health
Contact: Rachel Malen, rmalen@fredhuthc.org
Comprehensive Center for the Advancement of Scientific Strategies (COMPASS)
Public Health Sciences, BiostatisticsCOMPASS provides state-of-the-art study coordination, communication and statistical analysis services to scientific investigators participating multi-center studies.
Contact: Jackie Dahlgren, jdahlgre@fredhutch.org
Conquer the Common Cold
Vaccine and Infectious Disease Division, Infectious Disease SciencesWe are currently recruiting about 200 people to participate in our study. We hope that this study may provide information to help with designing a vaccine for Rhinovirus or for other viruses. Rhinoviruses are responsible for causing 30-50% of common colds. Some people report getting a lot of colds each year while others report never getting sick. This study will compare the immune response to the common cold (rhinovirus) between people who feel like they rarely have cold symptoms versus those who have them more often. We hope that by closely following the body’s specific immune responses in someone who has exposure to the common cold, we can better understand which responses may be required for a successful vaccine against the common cold.
Cook for Your Life!: Maintaining Diet and Physical Activity
Public Health Sciences, Cancer PreventionTo test the effects of in-person and e-communication (e.g., text, email) interventions on improving diet and physical activity among Latina breast cancer survivors.
Funding Agency: National Institutes of Health / National Cancer Institute
Contact: Lisa Levy, llevy@fredhutch
Cost Effectiveness Analysis of Stem Cell Transplant in Older MDS Patients
Public Health Sciences, Cancer PreventionResearchers compare the differences in cost and quality of life when using allogeneic stem cell transplant versus hypomethylating agents for patients aged 50 to 75 with myelodysplastic syndrome.
Funding Agency: National Institutes of Health
Contact: Jordan Steelquist, jsteelq@fredhutch.org
DOVE: A case-control study of ovarian cancer
- Mary Anne Rossing, Ph.D., D.V.M.
- Holly Harris, Sc.D., M.P.H.
Using two ovarian cancer case-control studies, scientists are trying to determine why some women develop ovarian tumors and others do not.
Funding Agency: National Cancer Institute
Contact: Holly Harris, hharris@fredhutch.org
Dexrazoxane and Prevention of Anthracycline-Related Cardiomyopathy in Childhood Cancer Survivors
Public Health Sciences, EpidemiologyScientists are determining the efficacy of dexrazoxane (DRZ) in reducing anthracycline-related cardiomyopathy among participants in DRZ phase 3 therapeutic trials.
Funding Agency: National Cancer Institute
Contact: Nancy Blythe, nblythe@fredhitch.org
Diet and Genetic Risk for Prostate Cancer
Public Health Sciences, Cancer PreventionUsing the data from the 12,000 Carotene and Retinol Efficacy Trial (CARET) participants, this study looks at the effects of both diet and dietary supplements, as well as polymorphisms in oxidative stress regulatory genes, on prostate cancer risk.
Funding Agency: National Cancer Institute
Contact: Diana Lowry, dlowry@fredhutch.org
Early Detection Research Network (EDRN)
Public Health Sciences, Cancer PreventionThe Data Management and Coordinating Center (DMCC) of the EDRN is jointly operated by Fred Hutch, the University of Washington, the University of Texas MD Anderson Cancer Center and COMPASS. It provides coordination and data management under the direction of the Steering Committee and develops statistical and analytical methods based for the network.
Funding Agency: National Institutes of Health
Contact: Royce Malnik, rmalnik@fredhutch.org
A Global Study of Colorectal Cancer Risk Factors
The Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO) is a worldwide consortium of researchers who are analyzing the genes of more than 75,000 participants. This data helps the team guide colorectal screening decisions based on a person’s genetic profile and lifestyle risk factors. GECCO researchers also study how the interplay among genetic and environmental factors affects cancer risk.
Selected Colorectal Cancer Clinical Trials
Clinical research is an essential part of the scientific process that leads to new treatments and better care. Clinical trials can also be a way for patients to get early access to new cutting-edge
therapies. Our clinical research teams are running clinical studies on various kinds of colorectal cancers.
Our Colorectal Cancer Researchers
Our interdisciplinary scientists and clinicians work together to prevent, diagnose and treat colorectal cancer as well as other cancers and diseases.
Patient Treatment & Care
Seattle Cancer Care Alliance, our clinical care partner, gives patients access to the comprehensive, world-class treatments developed at Fred Hutch.