Ultramarathon/Endurance Athlete Colorectal Cancer Study

The purpose of this investigational study is to answer the following question: What is the frequency of colorectal cancer in male and female endurance runners between the ages of 35 and 50? Inova has created this study to examine whether endurance runners have a different risk for colorectal cancer than the general population.

Ischemic runner's colitis is a widely reported consequence of long-distance running. Blood in the stool of endurance athletes is common. Generally, increased cell turnover in epithelial cells leads to a higher risk of genetic mutation, which raises the concern about whether extreme running may, in some instances, cause malignancy. Other than ischemia, there may be other causes that link endurance athletes to malignancies, including exercise-induced immunosuppression.

Inova recently evaluated three younger colon cancer patients who ran ultramarathons or several marathons who developed stage IV colon cancer and aggressive phenotypes. Though no clear link between endurance running and cancer has been previously established, and exercise is generally thought to decrease the risk of cancer, case reports and our own experience have raised the question about whether endurance running may increase the risk of cancer. We aim to further explore the potential increased risk of colorectal cancer in endurance athletes.

This study involves an FDA-approved screening procedure called colonoscopy. Colonoscopy is not routine in individuals who are less than 50 years of age and not considered at high risk for colon cancer.

This study is being funded by a grant from Inova Health System.

Inova Schar Cancer Institute and the Saville Cancer Screening and Prevention Center
A department of Inova Fairfax Hospital
8081 Innovation Park Dr.
Fairfax, VA 22031

• Age 35-50
• Self-reported endurance runners, defined by at least one of the following:
  • Run at least two "ultra running" events of 50 kilometers or more
  • Run 5 races of 26.2 miles or more
• Negative pregnancy test
• Additional eligibility in protocol.

• Known or suspected history of inflammatory bowel disease, familial adenomatous polyposis (FAP), or Lynch Syndrome
• Concomitant illness that would prevent adequate patient assessment or in the investigators’ opinion pose an added risk for study participants
• Any history or evidence of severe illness or any other condition that would make the patient, in the opinion of the investigator unsuitable for the study
• Subject is involved with a worker's compensation, personal injury, or other legal matters related to their health
• Subject is enrolled in a separate interventional clinical trial
• Additional ineligibility in protocol