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
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 bacterial community in tumors for 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
Coordinating Center for the Population-based Research to Optimize the Screening PRocess (PROSPR) Consortium
Public Health Sciences, EpidemiologyBuilding on the success of PROSPR I, PROSPR II investigators from a variety of disciplines and institutions are conducting research to improve the screening of cervical, colorectal, and lung cancers.
Funding Agency: National Cancer Institute
Contact: Marty Stiller, mstiller@fredhutch.org
Epidemiology of T-Cell Response in Colorectal Cancer
- Amanda Phipps, PhD
- Ulrike Peters, PhD
- SHUJI OGINO, MD HARVARD UNIVERSITY
Scientists measure aspects of the immune response in colorectal tumors, and relate that immune response to lifestyle factors, inherited genetic factors, and cancer survival.
Funding Agency: National Cancer Institute
Contact: Ulrike Peters, upeters@fredhutch.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
Exercise intervention in colorectal polyp patients (APPEAL) study
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
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
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
Proteomic and 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, we are identifying blood-based biomarkers that can accurately predict cancer recurrence.
Funding Agency: National Cancer Institute
Contact: Kathy Vickers, kvickers@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 (ColoCare) Study
Public Health Sciences, EpidemiologyThe ColoCare Study is a prospective cohort of newly diagnosed colorectal cancer patients. We are currently expanding this study to three new sites aimed at increasing our 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
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.