Colorectal cancers diagnosed before age 50 are three to four times more likely to carry a specific DNA mutation pattern linked to colibactin-producing bacteria than cancers diagnosed after age 50, indicating that exposure to these bacteria earlier in life may be linked to the increase in early-onset colorectal cancer.

Colorectal cancers diagnosed before age 40 are more likely to show specific DNA damage patterns linked to colibactin-producing bacteria than cancers diagnosed after age 70, suggesting that exposure to these bacteria earlier in life may be associated with faster development of tumors in the lower colon and rectum.

DNA damage caused by the bacterial toxin colibactin is found in the earliest genetic changes in colorectal cancer, suggesting that exposure to this toxin happens early in life and helps create the initial mutations that lead to cancer.

Colorectal tumors with specific DNA damage patterns caused by colibactin often do not contain the bacteria that produce it at the time of diagnosis, suggesting the bacteria were present earlier and have since been cleared.

In 11 countries, regions with higher rates of specific DNA damage patterns linked to colibactin-producing bacteria also have higher rates of colorectal cancer, suggesting that differences in exposure to these bacteria may help explain why cancer rates vary by location.

Certain strains of E. coli that produce a toxin called colibactin are linked to a specific pattern of DNA damage found in colorectal tumors. This DNA damage pattern is more commonly found in tumors from people diagnosed with colorectal cancer before age 55 compared to those diagnosed at age 59 or older.