Millions of patients are at serious risk of developing deadly colorectal cancer before the age of 50 because they have inflammatory bowel disease, says one of Britain’s top experts.
The lifelong condition, which triggers debilitating stomach pains, raises the risk of the cancer by around 600 per cent, says Professor Sarah Berry, a nutrition scientist at King’s College London.
Experts say that inflammatory bowel disease, also known as IBD, damages the lining of the bowels, increasing the chances of life-threatening tumours forming.
Colorectal cancer, also known as bowel cancer, is surging in young people in Britain and many other countries.
Once associated with old age, those aged under 50 in the UK are 50 per cent more likely to develop the cancer than people of the same age in the early 1990s.
Experts still do not know the exact cause of this rise. However, Prof Berry, who is leading a £20million study, called Prospect, hoping to solve the mystery of these rising numbers, says growing evidence suggest inflammatory bowel disease could be, in part, to blame.
Also known as IBD, it affects around half a million people in the UK and 2.4 million in the US, the majority of whom are under-50. IBD is an umbrella term for two conditions, Crohn’s disease and ulcerative colitis, both of which damage the bowels.
Research suggests that IBD is on the rise in the UK and, concerningly, thousands of patients are currently undiagnosed. Experts say finding and treating these patients is crucial for tackling early-age bowel cancer.
‘IBD patients have a higher risk of early-age colorectal cancer than the rest of the population,’ says Prof Sarah Berry, a nutritional scientist at King’s College London, who is leading a study hoping to solve the mystery of these rising numbers
‘IBD patients have a higher risk of early-age colorectal cancer than the rest of the population,’ says Prof Berry.
‘Research in Sweden has shown the condition leads to a six-fold increase in diagnoses. The main theory is that the persistent inflammation in the bowels triggers the cancer.’
Every year, around 44,000 people are diagnosed with bowel cancer in the UK. The disease kills around 17,000 over the same time period.
The first signs are often persistent changes in bowel habits – such as diarrhoea and constipation – as well as blood in the stool, abdominal pain, fatigue and unexplained weight loss.
Obesity, lack of exercise and alcohol have all been shown, over time, to raise the risk of the disease.
And, until recently, all research suggested the chances of developing bowel cancer rises with age.
But studies show a growing number of people under the age of 50 are developing the disease.
One of those struck down in recent years by the disease was broadcaster, journalist and campaigner Dame Deborah James, also known as Bowel Babe. Dame Deborah was diagnosed when she was 35. She died in 2022, aged 40.
Broadcaster, journalist and campaigner Dame Deborah James was diagnosed with bowel cancer when she was 35. She died in 2022, aged 40
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Meanwhile, former Dawson’s Creek actor James Van Der Beek was told he had bowel cancer in 2023 at the age of 46.
Experts say they are exploring a number of possible causes that could be behind this mystery rise in early-age bowel cancer.
In 2023, a study found that female patients born by cesarean delivery were more likely to experience early-onset colorectal cancer.
Another leading theory is that increased consumption of ultra-processed foods – those made with artificial ingredients – could be driving this rise. Studies suggest ultra-processed ingredients make up about 40 per cent of the British diet – one of the highest levels in Europe.
‘It’s already known that patients who have an unhealthy diet high in processed meats and sugary drinks are more likely to get bowel cancer,’ says Prof Berry.
‘There is also some evidence that additives found in ultra-processed foods could inflame the bowel and raise the risk of cancer. We don’t know that for certain but it’s something that needs to be investigated.’
Interestingly, research also suggests that ultra-processed foods may also be sparking a rise in the number of patients with IBD – the term used to describe Crohn’s disease and ulcerative colitis.
Crohn’s disease is an incurable condition in which parts of the digestive system become inflamed. The damage can be extensive, affecting the entire digestive tract from the mouth to the back passage.
It often causes severe pain, diarrhoea, exhaustion and weight loss. Crohn’s can also trigger pain in the joints, anus and eyes.
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James Van Der Bee was diagnosed with colorectal cancer in August 2023, aged just 46
Ulcerative colitis is similar, however, the inflammation only occurs in the gut. Symptoms include diarrhoea, blood in the poo, and regularly needing to go to the toilet.
Doctors aren’t sure what triggers these problems, but it is thought to be linked to an overactive immune system – fighter cells that are supposed to attack harmful toxins mistakenly destroy healthy tissue in the gut.
In 2021, a study published in the British Medical Journal found that patients who have diets high in ultra-processed foods are more likely to develop IBD.
And, crucially, in 2023, Swedish researchers published a study, in the medical journal Cancers, that found IBD patients were nearly 600 per cent more likely to develop early-age bowel cancer.
The study also found that patients with the high blood sugar condition type 2 diabetes, as well as high blood pressure, high cholesterol and a large waistline, were around 360 per cent more likely to get colorectal cancer at a young age.
The researchers involved concluded that patients with these underlying health problems should be considered for bowel cancer screening, in order to catch it early.
At present, in the UK, only those aged between 50 and 74 are screened for bowel cancer. This is done using an at-home poo test, called a faecal immunochemical test (FIT).
The researchers also added that effectively treating IBD could lower the risk of the cancer occurring.
Both Crohn’s and ulcerative colitis can be controlled by drugs called biologics. These injections limit the damage caused by the immune system to the body.
However, many IBD patients in the UK do not receive timely treatment. In 2024, a survey found that one in seven adults with IBD were only diagnosed and treated after an emergency hospital admission due to the severity of their symptoms.
