Identifying Accelerated Biological Age in Young Colorectal Cancer Patients Could Improve Post-Treatment Care
According to the National Cancer Institute, the rate of colorectal cancer has been steadily rising among adults younger than 50 since the 1990s. Understanding the causes behind this increase has puzzled doctors, but researchers at Moffitt Cancer Center say a new pilot study looking at biological age at diagnosis could be a piece of the puzzle.
Erin Siegel, PhD, a senior member in Moffitt’s Cancer Epidemiology Program, is among a team of researchers that is studying whether colorectal cancer patients diagnosed at younger ages have evidence of accelerated biological aging compared with patients diagnosed later in life. Chemical modification called methylation of DNA is a naturally occurring epigenetic process that occurs over the lifespan. Aging biomarkers based on patterns of DNA methylation called “epigenetic clocks” are one way to measure a person’s biological age that scientists are increasing using in cancer research.
Siegel will present these findings at the American Association of Cancer Research annual meeting in San Diego this week.
The first step to understanding the research, according to Laura Oswald, PhD, an assistant member in Moffitt’s Health Outcomes and Behavior Program, is deciphering the difference between chronological and epigenetic aging.
“Chronological age is tied to your birthday, so how many years you’ve been here on Earth,” Oswald said. “But different life experiences, exposures and the way you live your life can affect how your body ages biologically over time. If someone is 40 years old based on their chronological age, but biologically their body functions like it’s 35, that’s great. Conversely, you may be chronologically 40 years old, but your body may function as if it was 45 because it needed work a little harder. In this later case, because your biological age is older than your chronological age, you’re considered to be experiencing ‘accelerated aging.’”
“In this small pilot study using data from the ColoCare Study, we looked at a sample of colorectal cancer patients diagnosed across different age groups, including young adults, who have been diagnosed with this type of cancer way too early,” Siegel said. “We compared these young adult patients to patients diagnosed at an older ages to determine if there were differences in biological aging related to their age at diagnosis.”
The team also started to explore the effects of cancer treatments on rates of biological aging for those diagnosed at younger and older chronological ages.
The study included about 60 patients with colorectal cancer and found that age acceleration before cancer treatment did not vary by age at diagnosis. However, post-treatment, patients diagnosed at age 49 or younger had larger increases in age acceleration than those diagnosed at age 50 or older.
“It’s too early to fully understand what this means but the results warrant more investigation,” Oswald said.
Dr. Jacob Kresovich, an assistant member in Moffitt’s Cancer Epidemiology Program, is an expert in molecular markers of biological aging.
“DNA methylation-based measures of biological age are very interesting because they are based on a simple blood test,” Kresovich said. “And the information offered from these tests could be used to inform personalized care and improve health outcomes for survivors before and after their cancer treatment. This may be especially important for cancer patients diagnosed at younger ages, who have a whole life ahead of them.”
Siegel adds that seeing accelerated aging in younger patients may be a red flag for physicians to be on the lookout for longer term consequences.
“For example, these patients can be put on more surveillance in post-treatment settings so that we can catch potential negative outcomes early and intervene to improve their overall long-term health,” Siegel said.
The research could help identify modifiable targets for future interventions, according to Oswald. Modifiable or interventional treatments to slow, or event reverse, biological aging are of high interest to the research community.
“Once we study this on a larger scale, we may learn that some treatments impact biological aging more than others, and we can use that information to inform supportive care,” Oswald said. “It’s a long way down the line but it’s exciting to think that we could potentially slow the way cancer patients age.”
