Colorectal cancer is the third most common cancer worldwide, but its incidence is changing. While cases in older adults (over 65) are decreasing, early-onset colorectal cancer – cancer affecting individuals under the age of 50 – is on the rise. A new study in Cancer Prevention Research* suggests that biological age, a measure of how well the body is functioning rather than the number of years lived, may determine the risk of developing colorectal cancer. The study found that for every additional year a person’s body ages faster than expected, their risk of developing colon polyps increases by 16%. Given that polyps are precursors to colorectal cancer, this discovery has profound implications for early detection and prevention.
*Brown et al. Biological age acceleration and colonic polyps in persons under age 50. Cancer Prev Res (Phila), 1 February 2025;18(2):57-62
About Biological Age and Its Measurement
It is biological age, rather than actual chronological age, that reflects the condition of a person’s body and overall health. Epigenetic clocks, such as GrimAge, use DNA methylation levels at specific sites in the genome to estimate a person’s biological age. If the biological age exceeds the chronological age, it suggests accelerated aging, which is linked to a higher risk of chronic diseases, including cancer.
The Connection Between Biological Age and Colon Polyps
The study analysed 51 patients under 50 who underwent colonoscopies. Their biological ages were determined using blood samples, and researchers found a direct correlation between accelerated ageing and the presence of preneoplastic polyps (PNPs) – a key warning sign of colorectal cancer. Each additional year of accelerated ageing raised the odds of having a PNP by 16%. Interestingly, the study also found that men had a higher risk of developing polyps than women.
Early-Onset Colorectal Cancer (EOCRC) Trends
Over the past 15 years, colorectal cancer rates among adults under 50 have steadily risen. Nearly half of EOCRC cases occur in individuals under 45. Meanwhile, colorectal cancer incidence has declined in older adults, possibly due to improved screening. The increase in EOCRC cases suggests that traditional screening guidelines, which often begin at age 50, may not be sufficient. A more personalised approach based on biological age could improve early detection.
Incorporating Biological Age assessments into medical screenings could therefore identify high-risk individuals earlier and enable doctors to recommend preventative measures before cancer develops.
Male Sex as a Significant Risk Factor
Men have a higher risk of developing colorectal polyps compared to women. This may be due to:
- Hormonal differences (protective effects of oestrogen in women)
- Genetic predispositions
- Lifestyle factors such as diet and smoking
Preneoplastic Polyps (PNPs) and Their Role in Cancer Development
Polyps are abnormal growths in the colon that may develop into cancer over time. The two main types linked to CRC are:
- Tubular adenomas – The most common type, with moderate cancer risk.
- Sessile serrated adenomas – Less common but more likely to turn cancerous.
Early detection of these polyps is vital for preventing CRC.
The Importance of Early Screening for High-Risk Individuals
Current screening guidelines recommend colonoscopies starting at age 45–50, but individuals with a higher biological age may need screenings earlier. Identifying at-risk individuals based on biological markers could lead to personalised screening schedules, reducing cancer incidence and improving outcomes.
Minimising Unnecessary Colonoscopies While Enhancing Detection
Routine colonoscopies can be invasive and expensive. A biological age-based screening model could help focus resources on those most at risk, improving efficiency while minimising unnecessary procedures.
Lifestyle and Environmental Factors Affecting Biological Ageing
Biological age is influenced by lifestyle choices:
- Diet: A plant-rich diet can slow ageing by reducing inflammation.
- Exercise: Regular physical activity helps maintain a younger biological age.
- Smoking and alcohol: Both accelerate ageing and increase cancer risk.
- Stress management: Chronic stress contributes to accelerated ageing.
In Conclusion
This new study linking biological age with colon polyps provides us with valuable insights into colorectal cancer prevention. If biological age assessments become a routine part of medical screenings, they could lead to earlier detection, personalised screenings, and more effective prevention strategies.
By making lifestyle changes to slow biological ageing and staying proactive about screenings, individuals can take control and hopefully reduce their risk of developing many different forms of cancer.
