Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 28, 2025 4 weeks, 2 days, 12 hours, 13 minutes ago
Medical News: A recent study conducted by researchers at the University of Valencia and the Hospital Clínico Universitario of Valencia in Spain has raised critical questions about the potential connection between SARS-CoV-2 infection and colorectal cancer (CRC) especially anorectal cancer, in patients suffering from inflammatory bowel disease (IBD). Led by Dr. M.M. Boscá Watts and a multidisciplinary team across various departments, the research investigates whether the chronic inflammation associated with IBD, compounded by SARS-CoV-2 infection, could contribute to the development of colorectal cancer especially anorectal cancer.
SARS-CoV-2 and Anorectal Cancer
As early as 2023, Thailand
Medical News had already been sounding warnings that as a result of the newer variants of SARS-CoV-2 exhibiting tropism towards the gastrointestinal tract and its ability to exhibit viral persistence in these regions, the intestinal and rectal tissues could be subjected to constant inflammation, lesions and tissues damage possibly leading to anal dysplasia and anorectal cancers.
https://www.thailandmedical.news/news/can-sars-cov-2-cause-anal-dysplasia
SARS-CoV-2, the virus responsible for COVID-19, has been linked to various systemic effects, including impacts on cancer progression. The virus uses the ACE2 receptor to enter cells, and studies have shown that ACE2 is overexpressed in several types of malignancies, including colorectal adenocarcinoma. This
Medical News report explores groundbreaking findings from Spain on the potential roles of SARS-CoV-2 in influencing cancer pathways in vulnerable populations, such as IBD patients.
Understanding the Background
Patients with IBD are already at an increased risk of developing CRC due to chronic inflammation. This inflammation-driven pathway to cancer differs significantly from the traditional pathways seen in the general population. The researchers noted that CRC in IBD patients often manifests in the right colon and is more prevalent than in the non-IBD population, although incidence has declined over the years thanks to early detection and preventive measures.
However, between June 2022 and May 2024, researchers observed an unusual surge in CRC cases among IBD patients, particularly in the rectal and anal regions. This prompted them to investigate whether SARS-CoV-2 could play a role in triggering or accelerating cancer development in this specific subgroup.
The Study Details
The study focused on six male patients aged between 38 and 62 who were diagnosed with anorectal cancer. All the participants had long-standing IBD - three with Crohn’s Disease (CD) and three with Ulcerative Colitis (UC) - with disease durations ranging from 3 to 31 years. Their clinical profiles varied, with one being a smoker, one an ex-smoker, and two overweight individuals. Importantly, all patients had been vaccinated against COVID-19 and had p
reviously contracted the infection.
The researchers conducted detailed immunohistochemical analyses on tissue biopsies from these patients. Using the OMNIS Automated System and a monoclonal antibody specific to SARS-CoV-2, they found the virus’s proteins present in all tumor samples. This pattern, described as diffuse, cytoplasmic, and granular, was consistent across all cases.
Key Findings
-Cancer Type and Location: Four of the patients were diagnosed with mucinous adenocarcinoma (ADC), a subtype known for its aggressive behavior, while one had a conventional low-grade infiltrating ADC and another had intramucosal ADC. The cancers were located in the distal rectum and anal canal.
-Clinical Status: Five out of six patients were in endoscopic remission at the time of their cancer diagnosis, suggesting that the tumors developed despite well-managed IBD.
-Correlation with SARS-CoV-2: While no direct causation was established, the consistent presence of SARS-CoV-2 proteins in tumor tissues raises critical questions about the virus’s role as a potential trigger for CRC in IBD patients. The findings point to a possible link between prolonged viral presence in bowel mucosa and carcinogenesis.
Implications and Future Research
The study highlights several unanswered questions, including whether SARS-CoV-2 acts as a mere bystander in these cases or plays a direct role in tumor initiation and progression. It also raises concerns about whether the virus persists longer in the intestinal mucosa of IBD patients compared to the general population, potentially contributing to “long COVID” complications.
Future research will need to explore the mechanisms through which SARS-CoV-2 might influence cancer pathways. Prospective studies involving larger cohorts are essential to determine whether this phenomenon is widespread or limited to specific subpopulations.
Conclusion
This study underscores the need for heightened vigilance among healthcare providers managing IBD patients, particularly those with a history of SARS-CoV-2 infection. While the findings do not establish a direct causal relationship, they highlight the complex interplay between viral infections, chronic inflammation, and cancer development. Regular screening and close monitoring of IBD patients are imperative, especially in the context of emerging viral infections and their long-term implications.
The study findings were published in the peer-reviewed Journal of Crohn’s and Colitis.
https://academic.oup.com/ecco-jcc/article/19/Supplement_1/i757/7967367
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Medical News.
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https://www.thailandmedical.news/news/post-covid-19-individuals-advised-to-take-probiotics-as-study-shows-sars-cov-2-induced-gut-microbiome-dysbiosis-increases-risk-for-colorectal-cancer
https://www.thailandmedical.news/news/breaking-new-international-study-warns-that-sars-cov-2-infections-will-lead-to-cancers-especially-colorectal-cancers-due-to-disruption-in-autophagy
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