Bowel cancer rates are increasing globally among younger individuals, prompting researchers at King's College London to launch a major trial. The PROSPECT-UK community study aims to recruit 250,000 participants nationwide to investigate the crisis. This initiative is part of the global PROSPECT team, funded by Cancer Grand Challenges, to build a clearer picture of the drivers behind this trend across diverse populations.
The trial will monitor thousands of adults over an extended period, examining how factors such as diet, lifestyle, daily habits, gut health, and environmental exposures influence cancer risk. The study invites anyone over 18 living in the UK to contribute valuable information about their diet and lifestyle, helping researchers identify crucial patterns and trends.
Historically considered a disease of older adults, bowel cancer diagnoses in individuals under 50 have doubled since 1990. The UK currently faces one of the fastest-rising rates globally, with projections indicating a potential doubling of cases by 2030 compared to 2010 levels. While early-onset bowel cancer accounts for approximately 10% of all cases, its incidence is increasing by 1–2% annually in adults under 50.
Professor Sarah Berry, Professor of Nutritional Sciences at King's College London and PROSPECT-UK Chief Investigator, stated, “Over just a few generations our lifestyles, diets and environments have changed dramatically. But we don’t know which of these changes are increasing people’s risk of bowel cancer or which ones could help reduce it. We urgently need large-scale, long-term data to uncover the true causes of early-onset bowel cancer.”
Researchers highlight simple lifestyle changes that can generally reduce cancer risk, including increasing fibre intake, adopting a diet rich in fruits, vegetables, and whole foods, and maintaining an active lifestyle. Dr Rosiered-Brownson Smith, a PROSPECT-UK research associate at King's College London, noted, “In the UK, around 60% of our calorie intake comes from highly processed foods... PROSPECT-UK is innovative because, for the first time, we are collecting detailed, brand-level information about the foods people actually eat. This will allow us to better understand which foods and dietary patterns may be linked to the development of early-onset bowel cancer.”
Participants will complete online questionnaires on diet, lifestyle, environment, and health, and consent to link their electronic health records. A small group will provide blood and stool samples. Dr Rosiered-Brownson Smith also advised, “Unfortunately, many younger adults are diagnosed too late – partly because routine screening begins later in life and symptoms are often overlooked. Symptoms to watch include blood in stool, persistent abdominal pain, changes in bowel habits, and unexplained weight loss. Anyone experiencing these symptoms should seek medical advice.”
The PROSPECT-UK study is part of a global effort to understand the rise in early-onset bowel cancer. The team is funded by Cancer Research UK, the US National Cancer Institute, The Bowelbabe Fund for Cancer Research UK, and the French National Cancer Institute (INCa), through Cancer Grand Challenges. To participate, visit https://healthspanconnect.kcl.ac.uk/take-part/.
“"When I was diagnosed at 39, I had two young children and a life I thought I understood. I was a GP, I was active, and I had no family history of bowel cancer. I had even been running races and climbing a mountain shortly before my surgery. Cancer was the last thing I expected."
Dr Anisha Patel, an NHS GP and Lead Patient Advocate for Team PROSPECT, shared her personal experience of being diagnosed with stage IIIB rectal cancer at 39. Despite a healthy lifestyle and no family history, she underwent major surgery, chemotherapy, and continues to live with long-term health effects. Her experience highlights the need to understand the causes of early-onset bowel cancer and improve early detection.
Dr Patel added, “For younger people, a bowel cancer diagnosis can arrive in the middle of raising children, building a career and making plans for the future. Treatment can save your life, but it can also leave lasting changes. I’ve had to learn to live with bowel dysfunction, early menopause, infertility and nerve damage, as well as the emotional impact of everything that happened. I’ve also lost friends diagnosed young, leaving families and children behind. Those realities must remain visible when we talk about early onset cancer.”
She emphasised the importance of the research: “We still do not know exactly why more younger adults are developing bowel cancer. My experience makes me want to understand what risks we may be missing, whether exposures at different stages of life matter, and how we might identify people at risk sooner. That is why being part of Team PROSPECT means so much to me. I want patients to help shape the research from the outset, and I want that research to reflect the full diversity of the people affected. Finding answers feels like a race against time.”
