Colon cancer: Higher biological age linked to increased risk of polyps

• New research suggests that biological age — a measure of the body’s physiological state — could predict who is at higher risk for developing colon polyps, a key risk factor for colorectal cancer.
• For every extra year a person’s body aged faster than normal, their risk of developing colon polyps went up by 16%, according to the study.
• Researchers at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine say that individuals experiencing accelerated aging may benefit from earlier screenings.

Unlike your actual age, which is simply the number of years you’ve been alive, your biological age shows how well (or poorly) your body is functioning.

It’s affected by things like your genes, how you live (eating, exercise, sleep), and your environment (like stress or pollution).

The researchers found that accelerated aging occurs when biological age exceeds chronological age.

For example, someone who is 50 years old but has a biological age of 55 might notice their body isn’t working as well as it should.

While this idea might sound a bit abstract, past research has shown that aging faster than normal can increase the chances of serious health issues, like a higher risk of dying or developing cancers.

This study adds to the growing field of epigenetics, which looks at how our cells gradually lose their ability to function over time.

Corresponding author Shria Kumar, MD, MSCE, gastroenterologist and clinical epidemiologist at the Sylvester Comprehensive Cancer Center, explained the findings of this new study to Medical News Today.

Biological vs. chronological age

“Biological aging, which is a measure of your body’s age based on changes in DNA, is different than chronological age (simply the number of years since birth). It is thought to be more precise in reflecting our body’s true ‘age’ and has been studied as a marker of time to death and been shown to impact risk of developing certain cancers. Its role in cancer prevention is less clear, but here, we find promising associations in its risk with precancerous polyps in persons under age 50.”— Shria Kumar, MD, MSCE

Colorectal cancer rates among individuals under 50, referred to as early-onset colorectal cancer (EOCRC), have been steadily increasing.

“Early onset colorectal cancer (colon cancer in persons under age 50) is on the rise, but in absolute numbers, the risk is low. So there are a lot of people at risk, but very few will develop EOCRC,” Kumar said.

“What we then need is a risk-stratified approach to identify who is at the highest risk. Those people should then undergo colonoscopy, in which we can resect precancerous polyps and thereby PREVENT EOCRC,” Kumar explained.

The U.S. Preventive Services Task Force recently lowered its recommended starting age from 50 to 45.

“While ideal, we don’t presently understand enough about EOCRC risk to create such an approach. If [these findings are] validated on a larger scale, incorporating biological age into a risk calculator can help us identify which persons under age 50 are at highest risk of EOCRC.”— Shria Kumar

“Those people can then undergo colonoscopy, even if they are not yet 45 (the present age of screening initiation). While you may say well, you start at age 45 anyways, the median age of EOCRC diagnosis is 44 — so clearly, we have a lot to do as people will be diagnosed with cancer before being eligible for screening!” Kumar said.

“Our work sets the stage for what could be a promising risk-stratification approach to tackle EOCRC,” she added.

Colorectal cancer screening options include at-home stool-sample tests, which are more convenient for patients.

Despite these alternatives, colonoscopy remains the most effective method. This outpatient procedure, performed under sedation, allows doctors to identify and remove polyps — soft tissue growths that can develop into cancer.

Researchers noted that colonoscopy is unique because it provides both early detection and cancer prevention in a single procedure.

Risk factors for early-onset colorectal cancer, such as obesity, smoking, alcohol use, and certain lifestyle habits, are also associated with accelerated biological aging.

To study this link, the researchers examined people younger than age 50 who had colonoscopies. They used advanced DNA tests on blood samples to figure out each person’s biological age and compared it to their colonoscopy results.

They discovered that for every extra year a person’s body aged faster than normal, the risk of developing colon polyps went up by 16%.

Surprisingly, common risk factors like body weight and smoking didn’t have a strong link to polyp development. Instead, gender was the greatest factor, with men being more likely to develop pre-cancerous polyps.

The researchers emphasized the need to better understand why gender has such an impact on polyp risk and to continue studying biological age as a helpful health predictor.

The study suggests that colorectal cancer screening could be more effective by focusing on people whose bodies are aging faster than normal.

By giving high-risk individuals priority for colonoscopies, doctors could catch and prevent cancers early.

However, researchers say larger studies are needed to understand better the connection between biological age, actual age, and cancer risk.

These findings may suggest that biological age provides important health information that could change how we prevent cancer in the future.

Anton Bilchik, MD, PhD, MBA, FACS, surgical oncologist, chief of medicine and Director of the Gastrointestinal and Hepatobiliary Program at Providence Saint John’s Cancer Institute in Santa Monica, CA, who was not involved in this research, said, “There is a massive increase in young patients being diagnosed with colon cancer.”

“While studies suggest that there are several risk factors such as obesity, processed food, and physical inactivity, the cause, particularly in young patients without known risk factors, is unknown. This provocative study demonstrates that biological age, which can be evaluated by a blood test, is associated with a higher incidence of precancerous colon polyps.”— Anton Bilchik, MD, PhD, MBA, FACS

“While this is a small sample size, these findings could have major consequences in terms of colon cancer prevention while at the same time provide some insight into the increase in colon cancer among young adults,” Bilchik said.

“Further validation studies are needed, however, before the clinical value can be fully determined,” he added.