Diet-derived molecules called metabolites are the main drivers of young-onset colorectal cancer risk, especially those associated with red and processed meat, according to a new study.

The incidence of early-onset colorectal cancer (eoCRC) is rising and its cause is still unclear. Researchers at the Cleveland Clinic in Ohio, US, used AI to analyse metabolite and microbiome datasets, highlighted that one of the best ways a younger (<60 years) adult can prevent colorectal cancer is to discuss their diet with their health professional. 

“Researchers – ourselves included – have begun to focus on the gut microbiome as a primary contributor to colon cancer risk. But our data clearly shows that the main driver is diet. We already know the main metabolites associated with young-onset risk, so we can now move our research forward in the correct direction,” said senior author and gastrointestinal oncologist Dr Suneel Kamath.

The research team was excited to see diet play such a large role in cancer risk, because it is much easier to identify at-risk patients by counting the metabolites in their blood than it is to sequence the bacterial DNA in their stool for different microbes. “It can actually be very complicated and difficult to change your microbiome. While it’s not always easy, it is much simpler to change your diet to prevent colon cancer,” explained Dr Kamath. 

Researchers are now validating these findings in national datasets. If confirmed that these patients have higher levels of metabolites linked to arginine production and the urea cycle, they plan to explore whether specific diets or drugs that regulate these metabolic pathways could prevent or treat eoCRC.