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Notice of Special Interest (NOSI): Research on the Etiology, Early Detection, Screening and Prevention of Early-Onset Colorectal Cancer

National Institutes of Health

The purpose of this Notice of Special Interest (NOSI) is to solicit applications directed toward identifying, characterizing, and mitigating risk factors, identifying biomarkers for early detection, best screening modalities, and preventive interventions for early-onset colorectal cancer (EOCRC), defined as occurring before 50 years of age.

Given the likelihood that the rising incidence of early-onset cancers is multifactorial, successful applications may include investigation of genomic/epigenomic effects of environmental exposures or novel screening approaches that use currently available, non-invasive screening procedures (FIT, Cologuard, mSEPT9) or multi-cancer early detection using liquid biopsy tests. Validating existing screening procedures for this younger population or developing new approaches based on either epidemiology or basic biology methods would help disrupt the EOCRC alarming rise.

Although increasing at a concerning rate, the incidence of early-onset cancers is relatively uncommon; therefore, when appropriate, applicants may consider making use of existing cohorts and data repositories. Preclinical studies establishing new models to test critical gene–environment interactions would help define mechanisms of pathogenesis. Studies that identify biomarkers for early detection focused on how changes in screening practices and healthcare provider education could reduce mortality in this population are also encouraged. Studies investigating the role of risk factors in the context of differences in racial/ethnic distribution would also be responsive to this NOSI.

Approaches may include epidemiological and/or clinical cohort studies (retrospective or prospective) to characterize risk factors, identify biomarkers that correlate with risk, or preclinical studies focusing on the etiologic factors that affect the development and progression to early-onset cancer. Studies may include examining how dietary, environmental, infectious, and pharmaceutical exposures in childhood alter immune function, metabolism, and/or microbial interactions with the host that contribute to the initiation or progression of EOCRC. Clinical studies that help in planning/feasibility of randomized clinical trials that help to identify best screening modalities, and preventive interventions are encouraged. All research proposals are encouraged to evaluate factors of race, ethnicity, and socioeconomics on EOCRC.

This notice applies to due dates on or after January 5, 2023, and subsequent receipt dates through July 02, 2025.

NOT-CA-23-018