Research Finds Safer Way to Detect Colon Polyps

Microbiota signatures unique to specific precancerous colon polyps may lead to better tests with less risk

The key is to discover the polyp before they become cancerous. peterschreiber.media/Shutterstock

A new study conducted by researchers from the Broad Institute of MIT and Harvard, Harvard Medical School, and Massachusetts General Hospital linked precancerous colon polyps to specific gut bacteria.

Published in Cell Host & Microbe, the study compared the stool samples and colonoscopies of 971 participants. Stool samples were used to get a snapshot of the gut microbiome—the community of bacteria, viruses, and fungi that live primarily in the colon.

The study revealed a distinct microbial fingerprint among those who were found to have tubular adenomas and sessile serrated adenomas—two types of colon lesions that are considered premalignant. One of the largest studies of its kind, it detected 19 significantly different bacterial species in those patients with tubular adenomas and eight significantly different species in those with sessile serrated adenomas.

The finding suggests that a simple stool test may be able to reduce the number of more invasive and dangerous colonoscopies performed.

The research also raises the question of whether bacteria—in the form of a probiotic supplement or pill—could become a third way, with diet and medication, to reduce risk of colon cancer.

“The goal is ultimately to determine if there are species of bacteria we want to use to influence our patients’ outcomes. Getting to this point is still a ways away,” Dr. Daniel C. Chung, medical co-director of the Center for Cancer Risk Assessment at the Mass General Cancer Center, told The Epoch Times. “The other potential way this can be applied is to study whether we can use this as a diagnostic or risk-assessment measurement.”

That could drastically change the approach to early detection of colorectal cancers, which is the third most common cancer and is on the rise in developing countries and, more recently, among young adults. About 18,000 people younger than 50 were diagnosed with colorectal cancer in the United States in 2020, according to the National Cancer Institute. Similar trends have been documented in Canada, New Zealand, Australia, and some parts of Europe and Asia.

Colonoscopy—an invasive procedure requiring sedation recommended for adults as young as 45—is the gold standard test for detecting colorectal cancers. It has side effects and risks that make a more simple test an appealing alternative. Dr. Chung said the study makes a case for a stool analysis as a tool that could determine which patients might be in need of a colonoscopy.

Why Polyps Matter

Polyps—growths from clumps of abnormal cells—are still a bit of a mystery in the medical world. Without a known cause, colon polyps are more common in people 45 and older and in those who are overweight, have diabetes, have a family history of polyps, use tobacco, or have certain gastrointestinal conditions such as Crohn’s disease and ulcerative colitis.

It may take years for a polyp to turn into cancer, if it ever does, which is why colonoscopies are believed to be the best option for early detection.

“Understanding polyps is an important way to influence the rise of colon cancer,” Dr. Chung said. “Not every polyp becomes cancer. Most adults will get polyps, but most will not get colon cancer.”

Medical researchers are still trying to determine whether there is a way to tell which polyps will develop into cancer and which ones will not.

Colon polyps are currently detected and usually also removed via colonoscopy, which was scrutinized for not significantly reducing mortality in a study published last year in the New England Journal of Medicine. The study had more than 84,585 randomized participants from Poland, Norway, Sweden, and the Netherlands.

A Johns Hopkins study in 2018 also found that some outpatient centers have infection risks 100 times higher than expected for patients undergoing colonoscopies and upper gastrointestinal endoscopies.

Other Ways to Test

There are three tests currently used to help physicians determine whether someone should have a colonoscopy. Because colonoscopies are usually only recommended every 10 years, these other tests can help screen more frequently. In some instances, they are the only screening tests recommended for healthy adults.

The fecal immunochemical test and fecal occult blood tests both detect blood in the stool. Medicaid will pay for one of these tests annually. Usually, people with blood in their stool are referred for colonoscopies.

A stool DNA test, also called a Cologuard test, ​is able to detect changes in the cells of the colon by looking at DNA in the stool and blood. ​It’s recommended every three years for adults 45 to 85 who don’t have a high risk of or symptoms of colorectal cancer.

Rising Rates of Colon Cancer

While colorectal cancer rates are decreasing in older adults, they’ve been steadily increasing in adults 50 and younger. Colorectal cancer causes more deaths in the United States than all but two other types of cancer.

Nearly all colorectal cancers arise from a precancerous polyp, and one of the best ways to reduce the incidence of colorectal cancer is to stop growth at the polyp stage.

Risk factors for colorectal cancer and polyps include being overweight, having low physical activity levels, eating a diet high in red and processed meats, smoking, and using alcohol.

These risk factors also influence intestinal bacteria. It’s unknown whether the bacteria are initiating polyps or the polyps are progressing because of the microbial makeup, Dr. Chung said.

“There are these changes in the bacteria, but they aren’t necessarily because these bacteria have just changed. There are changes in our lifestyle that are changing the bacteria,” he said.

Lowering Risk

While there’s some genetic connection, polyps and colorectal cancer are largely preventable by avoiding risk factors. But in terms of actual therapies, studies haven’t found specific doses or duration of a given food, drug, or supplement that helps prevent problems.

“Yet some of the reviewed studies did show a link between a lower risk of colon cancer and use of nonsteroidal anti-inflammatory drugs (NSAIDs)—such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve)—and a higher intake of fruits, vegetables, and fiber. But other studies did not,” a Harvard Medical School article reads.

The article advised against taking NSAIDs without consulting a doctor. NSAIDs have been linked to a wide range of side effects, including gastrointestinal bleeding.

There are countless anecdotes of people resolving polyps or possible cancer, but these haven’t yielded a specific treatment or protocol that is widely accepted and used.

For example, Jillian Burne recently helped a client whose colonoscopy showed a possible cancerous lesion. Doctors wanted to operate, but Ms. Burne, a certified health coach and nutritional therapist, talked her client into giving her 30 days to try to reverse his gastrointestinal damage.

After analyzing his diet, which consisted of sushi eaten all over the world, she put him on a parasite protocol. He returned to the doctor for a sigmoidoscopy, a scope that examines the descending colon, and a second biopsy, and the precancerous cells were downgraded to inflammation.

“This client was very lucky that he was able to turn it around as fast as he did. He could have very well ended up in a diaper and a colostomy bag,” Ms. Burne told The Epoch Times. “The real problem I see is the fear tactics doctors use to drive people into procedures and medications.

“People are signing on the dotted lines before they leave the office and they don’t go home and research and find out that a lot of these are conditions that can be healed.”

Preventing Cancer

Normally, stomach acid will help kill parasites, but Ms. Burne said Americans largely suffer from low stomach acid due to diet and habits such as eating too fast, too much, and too frequently. Additionally, she said many people are eating when they are in a state of stress, and digestion requires relaxation. Processed and fast food made with cheap seed oils also cause inflammation that can aggravate the colon.

The body has the capacity to heal when it’s given the right environment. But Ms. Burne said it does take discipline to turn things around, and most people aren’t motivated to make meaningful changes in diet or exercise until faced with a drastic situation such as the potential loss of part of one’s colon.

“People get better when they tend to stick to the basics, just real food without the food colorings, without the dyes, without the toxic oils,” Ms. Burne said. “There’s no biological purpose for a polyp. The body finds ways to store [excess] if it can’t get rid of it in the normal elimination pathways. We’re putting too much stress on the system. People need to demand better care ... other than just cutting things out or getting a pill.”