Touati Benoukraf’s lab studies predisposition to colorectal cancer and preventative measures. (Submitted by Touati Benoukraf)

Colorectal cancer diagnoses are on the decline across the country, but Newfoundland and Labrador maintains the highest rate in Canada.

According to the Canadian Cancer Society, it’s still expected to be the fourth most commonly diagnosed cancer this year. That’s behind lung, breast and prostate cancers.

The organizations says over 25,000 people across the country will be diagnosed with the disease — around ten per cent of all new cancer cases in 2024.

Dr. Jennifer Gillis, director of surveillance for the Canadian Cancer Society, said they expect that 640 people will be diagnosed with colorectal cancer in Newfoundland and Labrador this year, with about 280 expected to die from the disease.

And while colorectal cancer rates across the country see an overall downswing, the demographics are changing.

“We recognize that decline that we’re seeing in Canada in colorectal cancer incidence rates may only be for older adults, as rates are reportedly increasing among younger adults,” Gillis said.

Reasons for an uptick in rates in people under 50 remain unclear, while increased screening to identify precancerous polyps is helping to cut rates in the older demographic.

About 92 per cent of cases of colorectal cancer are still expected among people over the age of 50.

N.L. specific 

But, Newfoundland and Labrador is at the peak of another, more startling statistic.

“Unfortunately, in Newfoundland, we have the highest rate, not only in Canada but in the world,” Touati Benoukraf said.

Benoukraf is an associate professor of genomics and bioinformatics at Memorial University, and Canada’s research chair in bioinformatics for personalized medicine.

In his lab at MUN, Benoukraf and his team team analyze large genomic data, specializing in colorectal cancer.

They start by studying both regular tissues and tumour tissues to see the differences. Then, they can find out what constitutes a predisposition to colorectal cancer and how tissues become cancerous.

Dr. Touati Benoukraf says Newfoundland and Labrador has the highest colorectal cancer rates in the world. (Submitted by Touati Benoukraf)

Benoukraf’s goal is to determine preventive measures and potentially find a cure for colorectal cancer.

But why does Newfoundland and Labrador rank higher in colorectal cancer rates than other provinces?

Benoukraf says there is less diversity among genetics in smaller population than those in more densely populated areas. Because of that, specific populations could experience a disease at a higher rate. He called this the Founder Effect, which happens in other islands throughout the world.

“This is one of the reasons I tackled this disease here,” he said. “It makes sense for me to work on a disease that is a huge burden for the local population.”

He categorizes the kinds of mutations that cause cancer into two types: germinal and somatic. Germinal mutations are a mutation that someone is born with, a predisposition to a particular disease. Somatic mutations can be provoked at any time in someone’s life, regardless of family genetics.

Both mutations need a trigger to activate the disease.

Benoukraf says when someone experiences cancer at a young age — under 50 years old — that is usually an indication of a predisposition. At an older age, it is generally due to circumstances in life like alcohol consumption, smoking or poor diet.

“And then you have a grey zone, which is 40, 45 to 65 which are hard to say,” he said.

And while there is no solid evidence, Benoukraf hypothesizes that this could mean there are more cases of cancer from predisposition than because of lifestyle.

Preventive measures 

Benoukraf says physical activity, limiting alcohol consumption and smoking, and a healthy diet are all preventative measures for cancers across the board.

Gillis shared that sentiment.

“Nearly half of all colorectal cancer cases can be prevented,” she said.

Gillis emphasized three of the most important preventative measures: know your own risk and family history, talk to your health-care provider about changes in your body and, for people between the ages of 50 and 75, participate in colorectal screening programs.

She said those programs can be done at home and could detect cancer early or find precancerous conditions that can be treated to reduce future cancerous events.

“It’s important for us to have these conversations,” she said.

“Sometimes they can be uncomfortable, but it’s so important for us to sit and talk with one another, understand our own risks, understand our family risk as well and just have these conversations.”

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