‘Silent’ condition suffered by millions that raises risk of early colon cancer

A hidden condition suffered by one in four Americans may raise the risk of fast-rising cancer in young people, a study suggests.

Scientists have discovered a link between early-onset colon cancer and fatty liver disease, a condition where excessive fat accumulates in the liver.

Suffered by 80 to 100million Americans, the disease often develops silently, causing minimal or no symptoms – but it can lead to inflammation in the body linked to cancer.

The most common kind is caused by alcohol, though sugary diets, obesity and smoking can lead to non-alcoholic liver disease (NAFLD).

The team found people under 50 with a history of NAFLD were up to 24 percent more likely to develop colon cancer than people without the condition.

And people who showed early signs of the disease had a 12 percent greater risk than people with no history of liver disease.

The researchers suggested the inflammation caused by NAFLD may travel to the colon, damaging cell DNA and leading to the formation of cancer cells.

The team South Korea said that while more research is needed, early colon cancer screening should be adopted for people with NAFLD. 

Bailey Hutchins, a social media influencer pictured here, died earlier this year from colorectal cancer at age 26

In the study of nearly 5million adults ages 20 to 49, men living with NAFLD were also 17 percent more likely than women to be struck by colorectal cancer.

The researchers tied this to men being more likely to smoke and be obese, risk factors for liver disease.

Writing in the study, they said: ‘Our findings revealed a strong link between NAFLD and early-onset CRC in young adults, suggesting the importance of implementing effective preventive strategies, particularly in populations with a growing burden of metabolic dysfunction.’

The findings come as colorectal cancer surges in young Americans, with rates in under-50s increasing from 8.6 cases per 100,000 people to 13 cases per 100,000 people in the last two decades. 

The study, published in the journal Clinical Gastroenterology and Hepatology, evaluated 4.6million adults in South Korea ages 20 to 49 from a South Korean insurance database. 

Of those, 2,733 developed early-onset colorectal cancer after an average of nine years.  

Each participant underwent routine health checks in 2009 and was followed until 2019. 

All participants were grouped into four categories: NAFLD, borderline NAFLD or no NAFLD. 

Fatty liver is diagnosed through a combination of physical exams, blood tests, and imaging studies, including ultrasound, CT scans, or MRIs. 

About 11 percent were diagnosed with NAFLD, 19 percent were borderline and 70 percent had no history of the condition. Participants in the NAFLD group tended to be older and male, smokers and mild-to-moderate drinkers. 

They also tended to have a higher BMI, waist circumference and blood pressure, all risk factors for liver disease. 

After taking risk factors into account, patients with NAFLD had a 24 percent increased risk of developing early colon cancer, and those in the borderline NAFLD group had a 12 percent higher chance compared to people without the condition.

And of those with NAFLD, men were 17 percent more likely than women to develop colorectal cancer.

As well as men living generally unhealthier lives, the researchers suggested the gender divide could be because the female sex hormone estrogen has been shown to promote the growth of healthy bacteria in the gut and protect against inflammation.

Smoking, a risk factor for NAFLD, is also more common in men, and women are more likely to eat non-inflammatory fruits and vegetables. 

NAFLD patients in their 20s were also 24 percent more likely to develop colon cancer than people in their 30s and 11 percent more likely than patients in their 40s.

The likelihood of developing colon cancer was also 18 percent greater for non-diabetics compared to people with diabetes, leading the experts to suggest NAFLD may be a better indicator of colon cancer risk than diabetes. 

The researchers wrote: ‘To the best of our knowledge, this is the first study to provide clinical evidence supporting a correlation between NAFLD and early-onset CRC.’ 

The team suggested NAFLD and early-onset colorectal cancer could be connected through shared ‘inflammatory pathways.’

Professional baseball player Trey Mancini, pictured here with wife Sara, was diagnosed with stage three colon cancer at age 28, despite having no symptoms

NAFLD often develops silently, causing inflammation and eventially permanent scarring of the liver (stock image)

Symptoms of fatty liver disease can be difficult to notice at first, other than fatigue. However, as the disease progresses, symptoms such as swelling, red palms, and jaundice appear

NAFLD creates inflammation that damages cell DNA and causes cells to rapidly replicate, increasing the risk of cancerous cells forming. 

According to the researchers, chronic liver inflammation also releases cytokines – signaling proteins that communicate with the immune system – which promote the growth of cancer cells. 

NAFLD also disrupts the function of bile acids, which leads to imbalances in the gut microbiome, a risk factor for colorectal cancer.  

Additionally, NAFLD raised the risk of tumors specifically in the lower left side of the colon and the rectum, suggesting the condition targets lower areas of the colon and rectum, though the exact mechanism is unclear. 

There were several limitations, including a lack of data on family history, colon cancer stage and colonoscopy history. 

The researchers wrote: ‘These findings highlight the need for multifaceted preventive strategies, including lifestyle interventions and expanded screening for younger populations with NAFLD.’