New findings suggest a stiffening colon may be fueling early-onset colorectal cancer in younger adults, with chronic inflammation reshaping the colon into an environment conducive to tumor growth, according to a recent study from UT Southwestern Medical Center.
This research, published in Advanced Science, marks a significant shift in understanding the disease’s origins. While overall colorectal cancer diagnoses have declined in older populations, cases among those under 50 have risen sharply, now accounting for approximately 12% of all colorectal cancer cases in the United States since 2020.
For decades, the focus on early-onset CRC has centered on lifestyle, obesity, and environmental factors, all potentially contributing to chronic intestinal inflammation. However, the exact biological mechanisms linking this inflammation to aggressive early-onset forms of cancer have remained largely unclear until now.
The biomechanics of colon stiffness
Dr. Emina Huang, Professor of Surgery at UT Southwestern and a lead researcher, highlighted that ongoing inflammation can lead to scarring, which slowly alters tissue structure and increases stiffness over time. This process is known to contribute to cancer development in other organs, such as the breast and pancreas, prompting the team to investigate its role in the colon.
Her team’s analysis of colon tissue from patients with both average-onset and early-onset CRC revealed a crucial difference: tissue from younger patients was significantly stiffer. This rigidity appeared not just within tumors but also in surrounding healthy areas, indicating these changes might precede full cancer development.
Further investigation into the cause of this stiffness pointed to collagen, a structural protein. Early-onset CRC patients exhibited denser, more mature, and uniformly aligned collagen, strongly suggesting extensive scarring. Gene activity analysis also showed higher expression of genes related to collagen metabolism, blood vessel formation, and inflammation, reinforcing the link between chronic inflammation and tissue stiffening.
According to Dr. Jacopo Ferruzzi, Assistant Professor at UT Dallas and UT Southwestern, “Our observations are consistent across multiple length scales and link connective tissue stiffening to altered biochemical signaling in cancer cells,” as reported by ScienceDaily.com on January 24, 2026. This stiff environment then alters how cancer cells behave, potentially accelerating their growth and spread.
Implications for early detection and treatment
Understanding the biomechanical forces at play in a stiffening colon presents new avenues for combating early-onset colorectal cancer. Identifying tissue stiffness as a precursor or enhancer of cancer growth could lead to novel diagnostic tools, allowing clinicians to screen for physical changes in the colon even before precancerous lesions are visible.
This new perspective opens the door for targeted therapies that might not only address the cancer cells themselves but also the physical environment supporting their development. For instance, interventions aimed at reducing inflammation or reversing tissue stiffness could become part of a comprehensive strategy to prevent or slow the progression of this aggressive disease in younger populations.
The findings also underscore the need for continued research into the precise signaling pathways activated by tissue rigidity, such as mechanotransduction. Unraveling these complex interactions will be crucial for developing innovative drugs or therapies that can interrupt the cycle of inflammation, stiffness, and cancer progression.
The insight that a stiffening colon contributes to early-onset colorectal cancer marks a pivotal moment in understanding this challenging disease. By shifting focus to the physical properties of tissue alongside genetic and environmental factors, researchers are better equipped to develop more effective strategies for early detection and personalized treatments, ultimately offering hope to younger adults facing this growing health concern.
