One of the more unfortunate distinctions Atlantic Canada has is the highest prevalence of colorectal cancer in the country.
Derrick Lee, assistant professor of mathematics, statistics and computer science at St. F.X. wants to find out why that is the case.
Lee was partly inspired to do the research because of the high incidence of colorectal cancer in his home province of Newfoundland. He said the national average for colorectal cancer is 65 persons per 100,000 people, based on new cases in Canada, for 2015.
“In Newfoundland, it’s almost two times that. It’s closer to 110 people per 100,000, and Nova Scotia is second, at around 89 to 90 per 100,000 people. There’s clearly something going on in this region.”
According to Lee, the research is in its early stages, and will focus on data from the Canadian Partnership for Tomorrow Project (CPTP), a portal that provides resources to study data relating to biology and disease in Canada.
Some of the main factors that could influence the prevalence of colorectal cancer in Atlantic Canada include genetic or diet-related factors.
As far as diet is concerned, Lee said that in Atlantic Canada, “we are notorious for not getting enough vegetables in Atlantic Canada. We eat processed and fried food too much. Is there are dietary component that may be playing a role that makes things even worse for us?”
It isn’t a stretch that diet may factor in, given that diet already plays a role in the rates of cardiovascular disease in the region.
“We have a lot of different gene mutations out there, we’re talking in the range of millions.” Lee said, adding that he hopes to spot a gene or enzyme that is more or less active, that my play a role in the prevalence of colorectal cancer in Atlantic Canada.
Lee is certain that genetics play a role, since colorectal cancer is something that appears in many familial cases.
“If you have a family history, you’re already at an increased risk for colorectal cancer.”
Lee said that both genetic and environmental factors need to be considered, since there are many carcinogens in a person’s environment – from diesel fumes to “the black stuff on a well-done steak.”
Expanding on that, Lee compared the body in processing carcinogens to a large sink. Under normal circumstances, when not being exposed to high levels of carcinogens, “the drain at the bottom will just remove the water,” but if you have a family history of a certain type of cancer, or a gene that makes you more susceptible to carcinogens, “eventually that drain won’t be able to keep up with the overflowing water.”
That overflow metaphor describes a situation when the body is not able to metabolize carcinogens or repair DNA damage fast enough, leading to the abnormal cell growth that becomes cancer.
“It’s never a straightforward situation. And that’s the goal, to see if there’s a familial aspect here that relates to a gene that maybe gets passed along,” Lee said. “The main thing (to ask) is, ‘Is this occurring more regularly among those who develop cancer, versus those who don’t?’ There’s a public health component.”
If the study isolates any particular genes that are linked to colorectal cancer, Lee said the results could work in a way like the BRCA 1 and 2 genes have been linked to breast cancer, and can serve as warning signs of a predisposition to it.
“There are probably genes in the background that do increase your risk, and they can be used as bio-markers to potentially identify people who are more susceptible,” Lee said. “This is where we’re heading to in the future – being able to have personalized medicine is going to become a reality.”
With a better understanding of genetic factors, people will have a clearer idea of how predisposed they are to conditions like colorectal cancer – and what sort of precautions they have to take to avoid them.
“Making (risk factors) more tangible and understandable is more important than anything else,” Lee said.