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.
 

Colon cancer
A colon cancer tissue scan. Fred Hutch

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, Epidemiology

Scientists 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 Prevention

Researchers 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, Epidemiology

Scientists 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 Prevention

Working 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, Epidemiology

This 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 Prevention

Through 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, Epidemiology

Scientists 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

Public Health Sciences, Epidemiology

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, Epidemiology

Building 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 Prevention

Researchers 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 Prevention

Scientists 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 Prevention

This 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, Epidemiology

Researchers 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.
Public Health Sciences, Cancer Prevention

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, Epidemiology

Scientists 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, Epidemiology

The 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 Prevention

Researchers 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, Epidemiology

Addressing 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 Prevention

Researchers 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, Epidemiology

Scientists 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, Epidemiology

Breast 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, Epidemiology

The 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, Epidemiology

After 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 Prevention

The 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, Epidemiology

The 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)

Public Health Sciences, Cancer Prevention

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, Epidemiology

Using 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 Prevention

Researchers 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 Prevention

The goal of the project is to build and enhance community capacity and infrastructure on childhood obesity initatives 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 Prevention

Working 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, Biostatistics

COMPASS 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

Cook for Your Life!: Maintaining Diet and Physical Activity

Public Health Sciences, Cancer Prevention

To 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 Prevention

Researchers 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

Public Health Sciences, Epidemiology

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, Epidemiology

Scientists 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 Prevention

Using 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 Prevention

The 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

Echocardiographic Change in Cancer Survivors at Risk for Cardiomyopathy

Public Health Sciences, Epidemiology

Scientists are comparing the echocardiographic changes in left ventricular function and geometry for survivors of childhood cancer who experienced cardiomyopathy to those of survivors who did not.

Funding Agency: National Cancer Institute

Contact: Nancy Blythe, nblythe@fredhutch.org

Featured Project

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.

See All Colorectal Cancer Clinical Trials

Fred Hutch campus

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.

Meet Our faculty
Seattle Cancer Care Alliance building

Patient Treatment & Care

Seattle Cancer Care Alliance, our clinical care partner, gives patients access to the comprehensive, world-class treatments developed at Fred Hutch.

Make an appointment
Last Modified, August 16, 2019