Name: 為什麼越來越多的年輕人患上結腸癌？ (Why More Young People Are Getting Colon Cancer)
Uploaded: 2025-09-10T09:53:48.000Z
Duration: 7 min 20 s

There's something kind of worrying going on in the world of cancers.

在癌症的世界裡，發生了一些令人擔憂的事情。

I mean, there's lots of… it's cancers. All worrying.

我的意思是，有很多......這是癌症。都令人擔憂

But more and more people under the age of 50 are being diagnosed with colorectal cancer.

但是，越來越多 50 歲以下的人被診斷出患有大腸癌。

In some countries, the number of cases has even doubled in recent decades.

近幾十年來，一些國家的病例數量甚至翻了一番。

Which is strange, since typically colorectal cancer is a disease that affects older adults.

這很奇怪，因為大腸癌通常是一種影響老年人的疾病。

And what's even stranger is that these young people don't seem to have any of the usual risk factors for colorectal cancer, like an inherited genetic mutation.

更奇怪的是，這些年輕人似乎並不具備任何罹患結直腸癌的常見風險因素，比如遺傳基因突變。

Plus, even once they realize, the damage may have already been done.

另外，即使他們意識到了，傷害可能也已經造成了。

But after some sleuthing, scientists might have an answer.

不過，經過一番調查，科學家們可能找到了答案。

While not every country has seen uniform increases in early-onset colorectal cancer, at least 27 of them have seen a jump.

雖然並非每個國家的早髮結直腸癌發病率都出現了一致的增長，但至少有 27 個國家的發病率出現了猛增。

In fact, in many higher-income nations, the overall incidence of colorectal cancer has gone down, which makes the rise in young people all the more dramatic.

事實上，在許多高收入國家，結直腸癌的總體發病率已經下降，這使得年輕人的發病率上升更加引人注目。

And if the number of youth cases keeps going up, then researchers think colorectal cancer could become the leading cause of cancer-related death among young adults by 2030.

研究人員認為，如果年輕病例的數量持續上升，那麼到 2030 年，結腸直腸癌可能會成為年輕人因癌症死亡的主要原因。

Researchers have been scrambling to find a cause in order to prevent those deaths, and they've largely come up empty.

為了避免這些死亡，研究人員一直在努力尋找原因，但基本上一無所獲。

But thanks to a 2025 study published in the journal Nature, they may have found an answer.

不過，由於 2025 年發表在《自然》雜誌上的一項研究，他們可能已經找到了答案。

The authors sequenced the entire genome of almost a thousand cancer samples from both early- and late-onset cases, from 11 countries across four continents.

作者對來自四大洲 11 個國家的近千個癌症樣本進行了全基因組測序，這些樣本既有早期發病的，也有晚期發病的。

Which is, like, pretty comprehensive as these things go.

就這些東西而言，這已經很全面了。

What they saw was a specific pattern of DNA mutations that looks like the pattern left behind by a bacterial toxin called colobactin.

他們看到的是一種特殊的DNA突變模式，這種模式看起來就像一種叫做colobactin的細菌毒素留下的模式。

And these mutations were 3.3 times more common in early-onset cases, which here means adults under 40 than in those diagnosed after the age of 70.

而這些突變在早發病例（這裡指 40 歲以下的成年人）中的發生率是 70 歲以後確診病例的 3.3 倍。

Researchers already knew that colobactin is linked with certain cases of colorectal cancer, but this is the first time they'd shown a link between it and early cases.

研究人員已經知道大腸菌素與某些結腸直腸癌病例有關，但這是他們第一次證明大腸菌素與早期病例有關。

And they think that those DNA mutations are building up early in life.

他們認為，這些 DNA 變異是在生命早期積累起來的。

Which basically puts them decades ahead of schedule for developing colorectal cancer.

這基本上讓他們提前幾十年患上大腸癌。

What is colobactin, and how does it lead to cancer?

什麼是大腸桿菌素，它如何導致癌症？

Colobactin 是一種所謂的基因毒素。

It's made by certain strains of E. coli bacteria.

它是由某些大腸桿菌菌株製造的。

And while you might hear about E. coli in scary contexts like food poisoning or UTI, it's often found as a usually harmless resident of your gut.

雖然你可能會在食物中毒或尿毒症等可怕的情況下聽說過大腸桿菌，但它通常是腸道中無害的居民。

E. coli make colobactin in order to fight off other bacteria.

大腸桿菌會製造大腸桿菌素來抵抗其他細菌。

Problem is, it doesn't just damage bacterial DNA.

問題是，它不僅會破壞細菌的 DNA。

Until as recently as 2020, we didn't really know a ton about how colobactin damages our genetic material.

直到 2020 年，我們才真正瞭解到可樂菌素是如何損害我們的遺傳物質的。

Because this sneaky little toxin is tricky to study.

因為這種鬼鬼祟祟的小毒素很難研究。

It doesn't last very long in a lab setting, and it's near impossible to separate out from other substances that E. coli makes, some of which are actually helpful for our bodies.

它在實驗室中的存活時間並不長，而且幾乎不可能與大腸桿菌製造的其他物質區分開來，其中一些物質實際上對我們的身體很有幫助。

It wasn't until other scientists created mini petri dish organ models called organoids and improved mathematical techniques for analyzing mutations that researchers could figure out what colobactin was up to.

直到其他科學家創建了被稱為有機體的迷你培養皿器官模型，並改進了分析突變的數學技術，研究人員才弄清了 colobactin 的作用。

In a 2020 study, biologists infected these mini organs with colobactin-making E. coli and looked at how the DNA in those cells changed.

在 2020 年的一項研究中，生物學家用製造大腸桿菌的大腸桿菌感染了這些微型器官，並觀察了這些細胞中 DNA 的變化情況。

What they discovered was a mutational signature, a kind of calling card colobactin leaves behind when it reacts with DNA.

他們發現了一種突變特徵，這是一種可樂菌素與 DNA 反應時留下的名片。

The same calling card was detected by the researchers in the 2025 study.

在 2025 年的研究中，研究人員也發現了同樣的問題。

And they can tell because it has two key mutations.

他們之所以能知道，是因為它有兩個關鍵的突變。

One, called SBS88, frequently swaps out one of the four building blocks of DNA, a thymine, for a different one, usually cytosine.

其中一種名為 SBS88 的病毒經常將 DNA 四大組成成分之一的胸腺嘧啶換成另一種，通常是胞嘧啶。

Another mutation, called ID18, inserts or deletes a small section of DNA.

另一種名為 ID18 的突變會插入或刪除一小段 DNA。

And that leads to what's called a frameshift.

Basically, this means the DNA isn't read in the way that it should be.

基本上，這意味著 DNA 無法以應有的方式讀取。

Like, imagine you have the sentence the fat cat sat.

比如，想象你有一句話，"肥貓坐著"。

Now, get rid of the E, but you keep the same spacing, and you get the fact at at.

現在，去掉 "E"，但保持相同的間距，就能得到 "at "的事實。

In the same way, if the spacing of the genetic code gets messed up, the cell's machinery can't read it correctly.

同樣，如果遺傳密碼的間距被打亂，細胞機器就無法正確讀取。

These two mutations are driver mutations, meaning they drive or spur on the development of cancer.

這兩種突變屬於驅動突變，意味著它們會驅動或刺激癌症的發展。

Specifically, if we're going to get in the weeds here, what might be happening with colorectal cancer is that colobactin, with all of its snipping and swapping of DNA, might be turning off a copy of a gene called APC.

具體來說，如果我們要深入探討，結腸直腸癌可能發生的情況是，大腸菌素在剪切和交換 DNA 的過程中，可能會關閉一個名為 APC 的基因拷貝。

And APC is a tumor suppressor gene, meaning one that's really important for keeping cancer in check.

而 APC 是一種腫瘤抑制基因，即對控制癌症非常重要的基因。

And it's especially important when it comes to colorectal cancer.

All right, but what does this have to do with early cases specifically?

好吧，但這與早期案件有什麼具體關係呢？

The authors of the 2025 study proposed that colobactin-producing strains of E. coli might have been getting more common in the second half of the 20th century, leading to more of the toxin in our guts.

2025 年研究的作者提出，在 20 世紀下半葉，大腸桿菌中產生大腸桿菌素的菌株可能越來越常見，從而導致我們的腸道中出現更多的這種毒素。

And what's really important here, and scary, is that these mutations tend to occur early in life.

而真正重要和可怕的是，這些突變往往發生在生命的早期。

Frighteningly, one of the researchers suggested that this could represent a head start for the cancer of up to 20 years, developing at age 40 instead of age 60.

令人震驚的是，其中一位研究人員認為，這可能意味著癌症的發病年齡提前了 20 年，即在 40 歲而不是 60 歲時發病。

So it's not like you can start taking probiotics in your 30s to ward off the bacteria, since the damage has already been done.

是以，你不可能在 30 多歲時就開始服用益生菌來抵禦細菌，因為傷害已經造成了。

作為一個 45 歲的人，我不喜歡這樣。

And there's still a ton that we don't know here.

Like, how are children being exposed to these bacteria?

比如，兒童是如何接觸到這些細菌的？

And are you more likely to be exposed if you have a certain lifestyle or live in a particular place?

如果你有特定的生活方式或生活在特定的地方，你是否更有可能受到感染？

Researchers are now starting studies to try and answer those questions.

研究人員目前正在開展研究，試圖回答這些問題。

And they're developing early detection tests that hunt out colobactin-related mutations in stool samples to catch potential cancers before they get too far.

他們還在開發早期檢測試驗，從糞便樣本中找出與大腸桿菌素相關的突變，以便在潛在癌症發展到一定程度之前將其揪出來。

But until we have more answers, there are things you can do.

但是，在我們得到更多答案之前，您可以做一些事情。

If you're 45 or older, you can get screened, or earlier if you have any worrying symptoms.

如果您的年齡在 45 歲或以上，就可以接受篩查，如果您有任何令人擔憂的症狀，也可以提前接受篩查。

這沒什麼大不了的。你可以做到的。

In addition, it's more important than ever for younger folks to be on the lookout for potential early signs of colorectal cancer.

此外，現在比以往任何時候都更需要年輕人警惕大腸癌的潛在早期症狀。

Changes in bowel habits that last more than a few days.

持續幾天以上的排便習慣改變。

Urgency to go that's not relieved by going.

Abdominal pain, weakness and fatigue, or unintended weight loss.

腹痛、虛弱和疲勞，或體重意外下降。

Now, all of that stuff could be explained by other things as well.

現在，所有這些東西也可以用其他東西來解釋。

But it's good to know so that if you're experiencing that stuff, you can go see a doctor.

但知道這一點很好，如果你遇到這種情況，可以去看醫生。

Especially if you're experiencing more than one of those things.

尤其是當你遇到不止一種情況時。

If it's nothing, you'll find out that it's nothing, and you will feel better.

如果沒什麼，你會發現沒什麼，你會感覺好些。

There's no better moment for me than after a colonoscopy, when they're like, you don't have colon cancer.

對我來說，最好的時刻莫過於做完結腸鏡檢查後，他們說你沒有結腸癌。

It's good news that researchers are making progress on this mystery, even though there's a lot of work yet to be done.

儘管還有很多工作要做，但研究人員在這個謎團上取得了進展，這是一個好消息。

Understanding the cause is always the first step.

Unfortunately, it's going to take time to put this understanding into action.

遺憾的是，將這種認識付諸行動需要時間。

So in the meantime, be informed, see your doctor if anything's weird, and keep rooting for those scientists.

是以，在此期間，一定要了解情況，如果有任何異常，請去看醫生，並繼續為那些科學家們加油。