Colorectal Cancer: From Genetics to Breakthrough Discoveries. Don't Ignore It!
May 8, 2026
Marzec (March) is the global month dedicated to raising awareness about colorectal cancer – one of the most common cancers affecting Poles and people worldwide. For years, the popular social campaign, under the slogan "Nie miej tego gdzieś" (Don't Ignore It), aims to make us all realize how important preventative screening and prompt reaction to any alarming signals are, because colorectal cancer is one of the few cancers we can prevent almost 100% today – precisely thanks to prevention.
Colorectal Cancer – What Is It and Where Is It Located?
Colorectal cancer, also known as colon cancer or rectal cancer, is a malignant tumor originating from the epithelial cells lining the large intestine. Malignant tumors are particularly dangerous cancers because they can spread to other organs. The large intestine is the final section of the digestive tract, which consists of:
The cecum (with the appendix)
The colon (ascending, transverse, descending, sigmoid)
The rectum
Cancer can develop in any of these sections, although it most commonly occurs in the colon and rectum.
Colorectal Cancer in Poland and Worldwide – The Scale of the Problem
Unfortunately, colorectal cancer is a significant health problem. In Poland, it is the second most frequently diagnosed cancer in men and the third in women, as well as the second most common cause of cancer-related deaths. Every year in Poland, there are approximately 18-20 thousand new cases. Alarmingly, data from EuropaColon Polska indicates an increase in cases among so-called "young adults" (under 50 years of age). The situation worldwide is similar – it is one of the most common malignant cancers. Therefore, the vigilance threshold must be lowered – blood in stool or a change in bowel habits in a 30-year-old should also be a signal for immediate diagnosis. Early detection is crucial for effective treatment and improved prognosis, which is why prevention and regular screening are so important.
Risk Factors – Who Is at Risk?
There are many factors that can increase the risk of developing colorectal cancer.
The most important include:
Age: The risk increases significantly after the age of 50.
Family history: The presence of colorectal cancer or colon polyps in family members (parents, siblings, children) increases the risk.
Inflammatory bowel diseases: Crohn's disease and ulcerative colitis.
Colon polyps: Especially adenomatous polyps, which can develop into cancer.
Lifestyle:
A diet low in fiber and high in red and processed meat.
Low physical activity.
Overweight and obesity.
Smoking.
Excessive alcohol consumption.
Hereditary cancer predisposition syndromes: Such as familial adenomatous polyposis (FAP) or Lynch syndrome.
Symptoms – What to Look For?
Early-stage colorectal cancer is often asymptomatic, which is why preventative screenings are so important. When symptoms do appear, they may include:
Changes in bowel habits: Diarrhea, constipation, or alternating between the two.
Blood in stool: May be visible to the naked eye or detected only in a stool test.
Abdominal pain, cramps, bloating.
Unexplained weight loss.
Weakness and fatigue (due to anemia).
A feeling of incomplete bowel emptying.
Graphic materials from the EuropaColon Polska Foundation (europacolonpolska.pl)
Screening – What Does Prevention Entail?
The primary preventative screening is colonoscopy, which allows for a thorough examination of the entire large intestine and simultaneous removal of any polyps (polypectomy). It is recommended for individuals over 50 years of age or younger if risk factors are present. This is crucial because we can remove a lesion before it has a chance to develop into malignant cancer.
Another important test is the fecal immunochemical test (FIT) for occult blood, which is less invasive and can be performed regularly. If the result is positive, further diagnostics are necessary, usually a colonoscopy.
Modern oncology is also increasingly linking the state of our gut to cancer risk. Studies suggest that an excess of specific bacteria (e.g., Fusobacterium nucleatum) can promote inflammation and carcinogenesis. Therefore, making lifestyle changes is often important for individuals at increased risk.
Scientific Novelties – A Breakthrough in Understanding Treatment Resistance
Research on colorectal cancer is constantly yielding new discoveries that could revolutionize treatment. One of the latest and most promising areas of research is understanding the mechanisms of resistance to targeted therapies and chemotherapy.
Recent scientific studies have shed new light on the role of the transcription factor POU2F1 in the development of chemotherapy resistance in colorectal cancer. This resistance is a serious challenge that significantly limits treatment effectiveness.
Treatment resistance occurs when a tumor, initially sensitive to chemotherapy, suddenly stops responding to it. The latest research on colorectal cancer sheds new light on this process, pointing to a specific culprit: the POU2F1 protein, which acts as a precise "on switch" for resistance in cancer cells. In tumors that have become resistant to treatment, this protein is present in massive excess. It acts as a sinister conductor: it not only drives tumor growth but, most importantly, renders standard chemotherapy useless.
How does this happen? The mechanism for protecting cancer cells from chemotherapy is extremely precise and involves several other proteins, including MDR2 – responsible for actively pumping anti-cancer drugs out of the cell. Under normal conditions, our "worn-out customs pump" MDR2 is removed from the cell, but POU2F1 effectively blocks this process. As a result, the number of MDR2 "pumps" in the cancer cell increases, and they immediately expel anti-cancer drugs before they can enter the cell and cause any harm to the cancer.
However, the most fascinating discovery is the mechanism by which POU2F1 manipulates cell metabolism. This process is based on so-called lactylation, which involves attaching special "chemical labels" to proteins. The entire mechanism resembles a complex chain reaction:
POU2F1 increases the production of another protein: MCT4, which in turn expels lactic acid from the cell.
A lower level of lactic acid inside the cell causes yet another protein, PPP1R11, to lose its "label" (lactylation).
The correct "label" (lactylation) on PPP1R11 is essential for it to be stable and to break down the aforementioned protein responsible for expelling anti-cancer drugs from the cell: MDR2. Without proper lactylation, it becomes unstable and stops working.
When this process is disrupted – PPP1R11 does not break down used MDR2 because POU2F1 inhibits this by increasing MCT4 – the control system for MDR2 fails, and the cell becomes an impregnable fortress for chemotherapy.
As a result, we cannot destroy the cancer cell with a drug that was working moments before.
Understanding this complex chain of events opens entirely new doors for medicine. Instead of blindly using stronger chemotherapy, scientists can now design drugs that:
Will directly block the action of POU2F1,
Will influence the lactylation process to "restore" the function of the PPP1R11 protein.
These discoveries not only highlight the complexity of colorectal cancer mechanisms and the need for further research but, most importantly, offer real hope for the development of personalized therapies. Thanks to them, in the future, we will be able to "disarm" the tumor's defense system and make the fight against the disease much more effective.
Genetic Testing – The Key to Early Detection and Prevention
It is particularly important to emphasize the role of genetic testing in the context of colorectal cancer. Approximately 5-10% of all colorectal cancer cases have a hereditary basis, related to the presence of mutations in specific genes.
The most common hereditary colorectal cancer predisposition syndromes include:
Hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome: Associated with mutations in DNA repair genes (e.g., MLH1, MSH2, MSH6, PMS2). Individuals with Lynch syndrome have a significantly increased risk of developing colorectal cancer, as well as other cancers (e.g., endometrial cancer, stomach cancer, ovarian cancer).
Familial adenomatous polyposis (FAP): Caused by a mutation in the APC gene, leading to the development of hundreds of polyps in the colon, which will almost certainly turn into cancer if not removed.
Why is genetic testing so important?
Early detection: It allows for the identification of individuals at high risk of developing the disease, who should be included in an intensive screening program, often starting at a younger age.
Prevention: In cases of cancer-predisposing mutations, it is possible to implement appropriate preventative measures, including even prophylactic removal of the colon (colectomy), to prevent cancer development.
Precise treatment: Understanding the genetic basis of the tumor can influence the choice of the most effective therapy.
Information for family: The result of a genetic test is important not only for the patient but also for their relatives, who may also be carriers of the mutation.
If there have been cases of colorectal cancer in your family, especially at a young age or in multiple family members, it is worth considering genetic testing for hereditary predispositions. These tests allow for the implementation of an individualized screening schedule, often starting from age 20-25. Early qualification for the high-risk group and the implementation of an appropriate preventative protocol helps to avoid the disease or initiate individualized treatment at early stages – dramatically increasing our chances in the fight against cancer.
Don't Ignore It – Get Tested!
The "Don't Ignore It" campaign reminds us that health is in our hands. Colorectal cancer is dangerous, but early detection makes it curable. In Poland, there is a Screening Program (PBP) that allows individuals aged 50–74 (or from 40 years old with a positive family history) to undergo a free colonoscopy without a referral. Many facilities offer the procedure with anesthesia, which eliminates discomfort.
Also, remember that genetic tests, which can help identify hereditary predispositions to colorectal cancer, are also available. It is worth consulting with your primary care physician and a genetic specialist to learn more and consider undergoing such tests. An advanced genetic testing panel along with a specialized consultation can also be performed through the Wellysa app, which will help everyone assess their risk of developing the most common hereditary cancers, including colorectal cancer.
Don't wait for pain, because early-stage colorectal cancer is completely painless.
It is always better to prevent than to treat, so act proactively and use the available tools: from simple FIT tests for occult blood, through genetic testing, to preventative colonoscopy. Regular screenings, a healthy lifestyle, and awareness of risk factors are our best weapons in the fight against this cancer.
Take care of your health this March. Graphic materials from the EuropaColon Polska Foundation (europacolonpolska.pl)
