Across the WHO European Region and beyond, young scientists are contributing to research on emerging public health challenges. Viviana Cortiana from Italy is studying the increasing incidence of colorectal cancers among her peers.
“We are witnessing an increase of colorectal cancer cases among younger populations,” she says. “As a young researcher and medical student, I am determined to better understand what drives this trend and how treatment outcomes for these young people can be improved.”
Since the beginning of her medical studies at the University of Bologna, she has deepened her understanding of medical research in various ways. Currently, she is researching how nutritional and metabolic factors can influence colorectal cancer at the Dana-Farber Cancer Institute in Boston, United States of America.
Involving young people enriches both students and research
“Engaging young people in research is sometimes perceived as primarily educational,” she explains. “But in reality, early-career researchers can contribute fresh perspectives, energy, interdisciplinary thinking and new skills, including digital skills. They also have the courage to question established paradigms and suggest innovative approaches, often raising questions relevant to young people specifically.”
She experienced this herself when starting her research at the Dana-Farber Cancer Institute. “Initially, I joined the lab mainly working on a different project. Some of the results got me curious about the role of nutritional exposures on tumour development, which was not something the lab was explicitly studying yet. I started discussing this with my mentor, and that’s where the new project started. Since then, we have also been studying the links between diet and colorectal cancer,” shares Viviana proudly.
Colorectal cancer is on the rise among young people – but awareness remains low
Colorectal cancer remains one of the most common cancers globally, and recent research shows a concerning increase in rates among younger adults.
“When diagnosed early, colorectal cancer can often have favourable outcomes. However, when it is detected later and has already metastasized, the situation is very different,” she continues. “That’s why targeted screening efforts are crucial interventions to save lives, as they can prevent and detect colorectal cancer for younger people.”
Awareness of colorectal cancer symptoms remains limited among both the public and some health professionals. This can contribute to delayed diagnosis in younger patients, who are not considered to be at high risk.
Alcohol – a lesser-known risk factor for colorectal cancer
Several modifiable risk factors are associated with colorectal cancer, including obesity, diets high in processed meat, low fibre intake, physical inactivity, tobacco use and alcohol consumption. However, awareness around some of these risk factors remains low.
For example. even though more than 1 in 10 (11%) of all colorectal cancer cases in the Region in 2020 were due to alcohol, WHO studies show that less than 40% of Europeans know that alcohol can cause colorectal cancer.
Alcohol is known to cause seven types of cancer. Ethanol – the active ingredient of alcoholic beverages – gets metabolized into acetaldehyde, a toxic and carcinogenic compound that can cause DNA damage. Alcohol may also contribute to oxidative stress and inflammation – processes associated with cancer development.
Emerging research also suggests that alcohol may disrupt the gut microbiome, the community of microorganisms living in the digestive tract, potentially contributing to inflammation and cancer .
“Our microbiome is in direct contact with what passes through our bowel. Therefore, it is very sensitive to what we eat and drink, including alcohol,” explains Viviana. “Alcohol can cause an imbalance in our microbiome, which can produce toxins. In clinical studies this has been associated with a higher risk of colon cancer development.”
Prevention and early detection of colorectal cancer
Colorectal cancer can often be prevented or detected early through a combination of risk reduction and screening programmes. Reducing exposure to known risk factors, such as avoiding alcohol and tobacco, maintaining a healthy diet and being physically active and participating in screening when offered, can all help reduce risk.
The most common symptoms of colorectal cancer include rectal bleeding, unintentional weight loss, abdominal pain, changes in bowel habits and iron-deficiency anaemia. Individuals who experience possible symptoms should seek medical advice so that a health-care provider can assess the symptoms and arrange further evaluation if needed.
More information
Viviana shared her story with us as a member of the Youth Alcohol Network, which was launched under the WHO European Union (EU)-funded project “Evidence into Action on Alcohol (EVID-ACTION)”. The project aims to increase awareness about harms from alcohol across 30 countries – the 27 EU Member States plus Iceland, Norway and Ukraine – and runs from 2022 to 2026.