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.
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.
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.
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.
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.
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.
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.