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Colorectal Cancer: Epidemiology, Etiology, and Molecular Basis

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Book cover The ASCRS Textbook of Colon and Rectal Surgery
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Abstract

Colorectal cancer (CRC) is a disease with a major worldwide burden. It is the fourth most frequently diagnosed malignancy in both sexes with almost 1 million people developing CRC annually. CRC is the third most common cause of cancer death in the world, responsible for 630,000 deaths annually. In the United States, CRC is the third most common cancer in men and women and the second most common cause of cancer death overall. CRC accounts for 11% of cancers diagnosed. It is estimated that 147,000 cases will be diagnosed in the United States in 2004 and that there will be 57,000 deaths from the disease.

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References

  1. Parkin DM, Bray FI, Devesa SS. Cancer burden in the year 2000. The global picture. Eur J Cancer 2001;37(suppl 8):S4–66.

    PubMed  Google Scholar 

  2. ShibuyaK, et al. Global and regional estimates of cancer mortality and incidence by site. II. Results for the global burden of disease 2000. BMC Cancer 2002;2(1):37.

    PubMed  Google Scholar 

  3. American Cancer Society Website Cancer Facts and Figures. 2004. Available at: http://www.cancer.org/downloads/STT/CAFF2004PWSecured.pdf.

  4. Boyle P, Langman JS. ABC of colorectal cancer: epidemiology. BMJ 2000;321(7264):805–808.

    CAS  PubMed  Google Scholar 

  5. Ries LA, et al. The annual report to the nation on the status of cancer, 1973–1997, with a special section on colorectal cancer. Cancer 2000;88(10):2398–2424.

    CAS  PubMed  Google Scholar 

  6. Rabeneck L, Davila JA, El‐Serag HB. Is there a true “shift” to the right colon in the incidence of colorectal cancer? Am J Gastroenterol 2003;98(6):1400–1409.

    PubMed  Google Scholar 

  7. O'Connell JB, et al. Rates of colon and rectal cancers are increasing in young adults. Am Surg 2003;69(10):866–872.

    PubMed  Google Scholar 

  8. Feldman G. Do Ashkenazi Jews have a higher than expected cancer burden? Implications for cancer control prioritization efforts. Isr Med Assoc J 2001;3(5):341–346.

    CAS  PubMed  Google Scholar 

  9. Laken SJ, et al. Familial colorectal cancer in Ashkenazim due to a hypermutable tract in APC. Nat Genet 1997;17(1):79–83.

    CAS  PubMed  Google Scholar 

  10. Prior TW, et al. The I1307K polymorphism of the APC gene in colorectal cancer. Gastroenterology 1999;116(1):58–63.

    CAS  PubMed  Google Scholar 

  11. Jemal A, et al. Cancer statistics, 2004. CA Cancer J Clin 2004;54(1):8–29.

    PubMed  Google Scholar 

  12. Cheng X, et al. Subsite‐specific incidence rate and stage of disease in colorectal cancer by race, gender, and age group in the United States, 1992–1997. Cancer 2001;92(10):2547–2554.

    CAS  PubMed  Google Scholar 

  13. Nelson RL, et al. The relation of age, race, and gender to the subsite location of colorectal carcinoma. Cancer 1997;80(2):193–197.

    CAS  PubMed  Google Scholar 

  14. Troisi RJ, Freedman AN, Devesa SS. Incidence of colorectal carcinoma in the U.S.: an update of trends by gender, race, age, subsite, and stage, 1975–1994. Cancer 1999;85(8):1670–1676.

    CAS  PubMed  Google Scholar 

  15. Lagiou P. Burden of cancer. In: Adami HO, Hunter D, Trichopoulos D, eds. Textbook of Cancer Epidemiology. Oxford: Oxford University Press; 2002:3–28.

    Google Scholar 

  16. Burkitt DP. Related disease—related cause? Lancet 1969;2(7632):1229–1231.

    CAS  PubMed  Google Scholar 

  17. FloodDM, et al. Colorectal cancer incidence in Asian migrants to the United States and their descendants. Cancer Causes Control 2000;11(5):403–411.

    CAS  PubMed  Google Scholar 

  18. Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin 1999;49(1):33–64, 1.

    CAS  PubMed  Google Scholar 

  19. WingoPA, et al. Long‐term trends in cancer mortality in the United States, 1930–1998. Cancer 2003;97(12 suppl):3133–3275.

    PubMed  Google Scholar 

  20. Rabeneck L, et al. Outcomes of colorectal cancer in the United States: no change in survival (1986–1997). Am J Gastroenterol 2003;98(2):471–477.

    PubMed  Google Scholar 

  21. Anderson WF, Umar A, Brawley OW. Colorectal carcinoma in black and white race. Cancer Metastasis Rev 2003;22(1):67–82.

    PubMed  Google Scholar 

  22. Morris AM, et al. Racial disparities in rectal cancer treatment: a population‐based analysis. Arch Surg 2004;139(2):151–155; discussion 156.

    PubMed  Google Scholar 

  23. Carethers JM. Racial and ethnic factors in the genetic pathogenesis of colorectal cancer. J Assoc Acad Minor Phys 1999;10(3):59–67.

    CAS  PubMed  Google Scholar 

  24. Mariotto A, et al. The prevalence of patients with colorectal carcinoma under care in the U.S. Cancer 2003;98(6):1253–1261.

    PubMed  Google Scholar 

  25. National Cancer Society Cancer Control and Population Sciences Estimated US Cancer Prevalence. Available at: http://cancercontrol.cancer.gov/ocs/prevalence. Accessed March 17, 2005.

  26. Nigro ND, et al. Effect of dietary beef fat on intestinal tumor formation by azoxymethane in rats. J Natl Cancer Inst 1975;54(2):439–442.

    CAS  PubMed  Google Scholar 

  27. Reddy BS, et al. Effect of quality and quantity of dietary fat and dimethylhydrazine in colon carcinogenesis in rats. Proc Soc Exp Biol Med 1976;151(2):237–239.

    CAS  PubMed  Google Scholar 

  28. Broitman SA, et al. Polyunsaturated fat, cholesterol and large bowel tumorigenesis. Cancer 1977;40(5 suppl):2455–2463.

    CAS  PubMed  Google Scholar 

  29. Hursting SD, Thornquist M, Henderson MM. Types of dietary fat and the incidence of cancer at five sites. Prev Med 1990;19(3):242–253.

    CAS  PubMed  Google Scholar 

  30. Willett WC. Dietary fat intake and cancer risk: a controversial and instructive story. Semin Cancer Biol 1998;8(4):245–253.

    CAS  PubMed  Google Scholar 

  31. Howe GR, et al. The relationship between dietary fat intake and risk of colorectal cancer: evidence from the combined analysis of 13 case‐control studies. Cancer Causes Control 1997;8(2):215–228.

    CAS  PubMed  Google Scholar 

  32. Stemmermann GN, Nomura AM, Heilbrun LK. Dietary fat and the risk of colorectal cancer. Cancer Res 1984;44(10):4633–4637.

    CAS  PubMed  Google Scholar 

  33. Goldbohm RA, et al. A prospective cohort study on the relation between meat consumption and the risk of colon cancer. Cancer Res 1994;54(3):718–723.

    CAS  PubMed  Google Scholar 

  34. Bostick RM, et al. Sugar, meat, and fat intake, and non‐dietary risk factors for colon cancer incidence in Iowa women (United States). Cancer Causes Control 1994;5(1):38–52.

    CAS  PubMed  Google Scholar 

  35. Giovannucci E, et al. Intake of fat, meat, and fiber in relation to risk of colon cancer in men. Cancer Res 1994;54(9): 2390–2397.

    CAS  PubMed  Google Scholar 

  36. Willett WC, et al. Relation of meat, fat, and fiber intake to the risk of colon cancer in a prospective study among women. N Engl J Med 1990;323(24):1664–1672.

    CAS  PubMed  Google Scholar 

  37. Flood A, et al. Meat, fat, and their subtypes as risk factors for colorectal cancer in a prospective cohort of women. Am J Epidemiol 2003;158(1):59–68.

    PubMed  Google Scholar 

  38. Kushi L, Giovannucci E. Dietary fat and cancer. Am J Med 2002;113(suppl 9B):63S–70S.

    CAS  PubMed  Google Scholar 

  39. Bingham SA, et al. Does increased endogenous formation of N‐nitroso compounds in the human colon explain the association between red meat and colon cancer? Carcinogenesis 1996;17(3):515–523.

    CAS  PubMed  Google Scholar 

  40. de Kok TM, van Maanen JM. Evaluation of fecal mutagenicity and colorectal cancer risk. Mutat Res 2000;463(1):53–101.

    CAS  PubMed  Google Scholar 

  41. Sandhu MS, White IR, McPherson K. Systematic review of the prospective cohort studies on meat consumption and colorectal cancer risk: a meta‐analytical approach. Cancer Epidemiol Biomarkers Prev 2001;10(5):439–446.

    CAS  PubMed  Google Scholar 

  42. Norat T, et al. Meat consumption and colorectal cancer risk: dose‐response meta‐analysis of epidemiological studies. Int J Cancer 2002;98(2):241–256.

    CAS  PubMed  Google Scholar 

  43. Elmstahl S, et al. Dietary patterns in high and low consumers of meat in a Swedish cohort study. Appetite 1999;32(2):191–206.

    CAS  PubMed  Google Scholar 

  44. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition and the prevention of cancer: a global perspective. Washington DC: American Institute for Cancer Research; 1997.

    Google Scholar 

  45. Michels KB, et al. Prospective study of fruit and vegetable consumption and incidence of colon and rectal cancers. J Natl Cancer Inst 2000;92(21):1740–1752.

    CAS  PubMed  Google Scholar 

  46. Voorrips LE, et al. Vegetable and fruit consumption and risks of colon and rectal cancer in a prospective cohort study: The Netherlands Cohort Study on Diet and Cancer. Am J Epidemiol 2000;152(11):1081–1092.

    CAS  PubMed  Google Scholar 

  47. McCullough ML, et al. A prospective study of whole grains, fruits, vegetables and colon cancer risk. Cancer Causes Control 2003;14(10):959–970.

    PubMed  Google Scholar 

  48. Terry P, et al. Fruit, vegetables, dietary fiber, and risk of colorectal cancer. J Natl Cancer Inst 2001;93(7):525–533.

    CAS  PubMed  Google Scholar 

  49. Flood A, et al. Fruit and vegetable intakes and the risk of colorectal cancer in the Breast Cancer Detection Demonstration Project follow‐up cohort. Am J Clin Nutr 2002;75(5):936–943.

    CAS  PubMed  Google Scholar 

  50. Schatzkin A, et al. Lack of effect of a low‐fat, high‐fiber diet on the recurrence of colorectal adenomas. Polyp Prevention Trial Study Group. N Engl J Med 2000;342(16):1149–1155.

    CAS  PubMed  Google Scholar 

  51. Sengupta S, Tjandra JJ, Gibson PR. Dietary fiber and colorectal neoplasia. Dis Colon Rectum 2001;44(7):1016–1033.

    CAS  PubMed  Google Scholar 

  52. Fuchs CS, et al. Dietary fiber and the risk of colorectal cancer and adenoma in women. N Engl J Med 1999;340(3):169–176.

    CAS  PubMed  Google Scholar 

  53. PetersU, et al. Dietary fibre and colorectal adenoma in a colorectal cancer early detection programme. Lancet 2003;361 (9368):1491–1495.

    PubMed  Google Scholar 

  54. Bingham SA, et al. Dietary fibre in food and protection against colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC): an observational study. Lancet 2003;361(9368):1496–1501.

    PubMed  Google Scholar 

  55. Asano T, McLeod RS. Dietary fibre for the prevention of colorectal adenomas and carcinomas. Cochrane Database Syst Rev 2002(2):CD003430.

    Google Scholar 

  56. Alberts DS, et al. Lack of effect of a high‐fiber cereal supplement on the recurrence of colorectal adenomas. Phoenix Colon Cancer Prevention Physicians’ Network. N Engl J Med 2000;342(16):1156–1162.

    CAS  PubMed  Google Scholar 

  57. Bonithon‐Kopp C, et al. Calcium and fibre supplementation in prevention of colorectal adenoma recurrence: a randomised intervention trial. European Cancer Prevention Organisation Study Group. Lancet 2000;356(9238):1300–1306.

    PubMed  Google Scholar 

  58. Mac LennanR, et al. Randomized trial of intake of fat, fiber, and beta carotene to prevent colorectal adenomas. The Australian Polyp Prevention Project. J Natl Cancer Inst 1995;87(23):1760–1766.

    CAS  Google Scholar 

  59. McKeown‐Eyssen GE, et al. A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. Toronto Polyp Prevention Group. J Clin Epidemiol 1994;47(5): 525–536.

    PubMed  Google Scholar 

  60. Baron JA, et al. Calcium supplements for the prevention of colorectal adenomas. Calcium Polyp Prevention Study Group. N Engl J Med 1999;340(2):101–107.

    CAS  PubMed  Google Scholar 

  61. Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev 2004(1):CD003548.

    Google Scholar 

  62. Bergsma‐Kadijk JA, et al. Calcium does not protect against colorectal neoplasia. Epidemiology 1996;7(6):590–597.

    PubMed  Google Scholar 

  63. Wu K, et al. Calcium intake and risk of colon cancer in women and men. J Natl Cancer Inst 2002;94(6):437–446.

    PubMed  Google Scholar 

  64. McCullough ML, et al. Calcium, vitamin D, dairy products, and risk of colorectal cancer in the Cancer Prevention Study II Nutrition Cohort (United States). Cancer Causes Control 2003;14(1):1–12.

    PubMed  Google Scholar 

  65. Cho E, et al. Dairy foods, calcium, and colorectal cancer: a pooled analysis of 10 cohort studies. J Natl Cancer Inst 2004;96(13):1015–1022.

    CAS  PubMed  Google Scholar 

  66. Kim YI. Folate, colorectal carcinogenesis, and DNA methylation: lessons from animal studies. Environ Mol Mutagen 2004;44(1):10–25.

    CAS  PubMed  Google Scholar 

  67. Kim YI. Role of folate in colon cancer development and progression. J Nutr 2003;133(11 suppl 1):3731S–3739S.

    CAS  PubMed  Google Scholar 

  68. Hunter DJ. In: Environmental Mutagen Society Colon Cancer Conference, 2003, Miami Florida.

    Google Scholar 

  69. U.S. Food and Drug Administration. Food standards: amendment of standards of identity for enriched grain products to require addition of folic acid. Final rule. 21 DFR Parts 136, 137, and 139. Fed Regist 1996;61:8781–8807.

    Google Scholar 

  70. Longnecker MP, et al. A meta‐analysis of alcoholic beverage consumption in relation to risk of colorectal cancer. Cancer Causes Control 1990;1(1):59–68.

    CAS  PubMed  Google Scholar 

  71. Cho E, et al. Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies. Ann Intern Med 2004;140(8):603–613.

    PubMed  Google Scholar 

  72. Potter JD. Colorectal cancer: molecules and populations. J Natl Cancer Inst 1999;91(11):916–932.

    CAS  PubMed  Google Scholar 

  73. Hawk ET, Umar A, Viner JL. Colorectal cancer chemoprevention: an overview of the science. Gastroenterology 2004;126(5):1423–1447.

    PubMed  Google Scholar 

  74. Garcia Rodriguez LA, Huerta‐Alvarez C. Reduced incidence of colorectal adenoma among long‐term users of nonsteroidal antiinflammatory drugs: a pooled analysis of published studies and a new population‐based study. Epidemiology 2000;11(4):376–381.

    CAS  PubMed  Google Scholar 

  75. Garcia‐Rodriguez LA, Huerta‐Alvarez C. Reduced risk of colorectal cancer among long‐term users of aspirin and nonaspirin nonsteroidal antiinflammatory drugs. Epidemiology 2001;12(1):88–93.

    PubMed  Google Scholar 

  76. Gwyn K, Sinicrope FA. Chemoprevention of colorectal cancer. Am J Gastroenterol 2002;97(1):13–21.

    CAS  PubMed  Google Scholar 

  77. Asano TK, McLeod RS. Nonsteroidal anti‐inflammatory drugs and aspirin for the prevention of colorectal adenomas and cancer: a systematic review. Dis Colon Rectum 2004;47(5):665–673.

    CAS  PubMed  Google Scholar 

  78. Asano TK, McLeod RS. Non steroidal anti‐inflammatory drugs (NSAID) and aspirin for preventing colorectal adenomas and carcinomas. Cochrane Database Syst Rev 2004(2):CD004079.

    Google Scholar 

  79. Gann PH, et al. Low‐dose aspirin and incidence of colorectal tumors in a randomized trial. J Natl Cancer Inst 1993;85(15): 1220–1224.

    CAS  PubMed  Google Scholar 

  80. Baron JA, et al. A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med 2003;348(10):891–899.

    CAS  PubMed  Google Scholar 

  81. Sandler RS, et al. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med 2003;348(10):883–890.

    CAS  PubMed  Google Scholar 

  82. Benamouzig R, et al. Daily soluble aspirin and prevention of colorectal adenoma recurrence: one‐year results of the APACC trial. Gastroenterology 2003;125(2):328–336.

    CAS  PubMed  Google Scholar 

  83. Giardiello FM, et al. Treatment of colonic and rectal adenomas with sulindac in familial adenomatous polyposis. N Engl J Med 1993;328(18):1313–1316.

    CAS  PubMed  Google Scholar 

  84. Giardiello FM, et al. Primary chemoprevention of familial adenomatous polyposis with sulindac. N Engl J Med 2002;346 (14):1054–1059.

    CAS  PubMed  Google Scholar 

  85. Labayle D, et al. Sulindac causes regression of rectal polyps in familial adenomatous polyposis. Gastroenterology 1991;101 (3):635–639.

    CAS  PubMed  Google Scholar 

  86. Steinbach G, et al. The effect of celecoxib, a cyclooxygenase‐2 inhibitor, in familial adenomatous polyposis. N Engl J Med 2000;342(26):1946–1952.

    CAS  PubMed  Google Scholar 

  87. Singh G, Triadafilopoulos G. Epidemiology of NSAID induced gastrointestinal complications. J Rheumatol Suppl 1999;56:18–24.

    CAS  PubMed  Google Scholar 

  88. Wolfe MM, Lichtenstein DR, Singh G. Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs. N Engl J Med 1999;340(24):1888–1899.

    CAS  PubMed  Google Scholar 

  89. Rahme E, et al. The cyclooxygenase‐2‐selective inhibitors rofecoxib and celecoxib prevent colorectal neoplasia occurrence and recurrence. Gastroenterology 2003;125(2):404–412.

    CAS  PubMed  Google Scholar 

  90. Gupta RA, Dubois RN. Colorectal cancer prevention and treatment by inhibition of cyclooxygenase‐2. Nat Rev Cancer 2001;1(1):11–21.

    CAS  PubMed  Google Scholar 

  91. BresalierRS, et al. Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 2005;352(11):1092–1102.

    CAS  PubMed  Google Scholar 

  92. Suleiman S, Rex DK, Sonnenberg A. Chemoprevention of colorectal cancer by aspirin: a cost‐effectiveness analysis. Gastroenterology 2002;122(1):78–84.

    PubMed  Google Scholar 

  93. Ladabaum U, et al. Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer. A cost‐effectiveness analysis. Ann Intern Med 2001;135(9):769–781.

    CAS  PubMed  Google Scholar 

  94. Hur C, Simon LS, Gazelle GS. The cost‐effectiveness of aspirin versus cyclooxygenase‐2‐selective inhibitors for colorectal carcinoma chemoprevention in healthy individuals. Cancer 2004;101(1):189–197.

    PubMed  Google Scholar 

  95. Arguedas MR, Heudebert GR, Wilcox CM. Surveillance colonoscopy or chemoprevention with COX‐2 inhibitors in average‐risk post‐polypectomy patients: a decision analysis. Aliment Pharmacol Ther 2001;15(5):631–638.

    CAS  PubMed  Google Scholar 

  96. Grodstein F, Newcomb PA, Stampfer MJ. Postmenopausal hormone therapy and the risk of colorectal cancer: a review and meta‐analysis. Am J Med 1999;106(5):574–582.

    CAS  PubMed  Google Scholar 

  97. RossouwJE, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002;288(3):321–333.

    CAS  PubMed  Google Scholar 

  98. Chlebowski RT, et al. Estrogen plus progestin and colorectal cancer in postmenopausal women. N Engl J Med 2004;350 (10):991–1004.

    CAS  PubMed  Google Scholar 

  99. Rymer J, Wilson R, Ballard K. Making decisions about hormone replacement therapy. BMJ 2003;326(7384):322–326.

    PubMed  Google Scholar 

  100. Slattery ML, et al. Estrogens reduce and withdrawal of estrogens increase risk of microsatellite instability‐positive colon cancer. Cancer Res 2001;61(1):126–130.

    CAS  PubMed  Google Scholar 

  101. Caan BJ, et al. Body size and the risk of colon cancer in a large case‐control study. Int J Obes Relat Metab Disord 1998;22(2): 178–184.

    CAS  PubMed  Google Scholar 

  102. Kune GA, Kune S, Watson LF. Body weight and physical activity as predictors of colorectal cancer risk. Nutr Cancer 1990;13(1–2):9–17.

    CAS  PubMed  Google Scholar 

  103. Lin J, et al. Body mass index and risk of colorectal cancer in women (United States). Cancer Causes Control 2004;15(6): 581–589.

    PubMed  Google Scholar 

  104. Terry PD, Miller AB, Rohan TE. Obesity and colorectal cancer risk in women. Gut 2002;51(2):191–194.

    CAS  PubMed  Google Scholar 

  105. Murphy TK, et al. Body mass index and colon cancer mortality in a large prospective study. Am J Epidemiol 2000;152(9): 847–854.

    CAS  PubMed  Google Scholar 

  106. Terry P, et al. Body weight and colorectal cancer risk in a cohort of Swedish women: relation varies by age and cancer site. Br J Cancer 2001;85(3):346–349.

    CAS  PubMed  Google Scholar 

  107. Slattery ML, et al. Body mass index and colon cancer: an evaluation of the modifying effects of estrogen (United States). Cancer Causes Control 2003;14(1):75–84.

    CAS  PubMed  Google Scholar 

  108. Slattery ML. Physical activity and colorectal cancer. Sports Med 2004;34(4):239–252.

    PubMed  Google Scholar 

  109. Woodson K, et al. Loss of insulin‐like growth factor‐II imprinting and the presence of screen‐detected colorectal adenomas in women. J Natl Cancer Inst 2004;96(5):407–410.

    CAS  PubMed  Google Scholar 

  110. Slattery ML, et al. Associations among IRS1, IRS2, IGF1, and IGFBP3 genetic polymorphisms and colorectal cancer. Cancer Epidemiol Biomarkers Prev 2004;13(7):1206–1214.

    CAS  PubMed  Google Scholar 

  111. Sandhu MS, et al. Association between insulin‐like growth factor‐I: insulin‐like growth factor‐binding protein‐1 ratio and metabolic and anthropometric factors in men and women. Cancer Epidemiol Biomarkers Prev 2004;13(1):166–170.

    CAS  PubMed  Google Scholar 

  112. Friedenreich CM, Orenstein MR. Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr 2002;132(11 suppl):3456S–3464S.

    CAS  PubMed  Google Scholar 

  113. Giovannucci E. An updated review of the epidemiological evidence that cigarette smoking increases risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2001;10(7):725–731.

    CAS  PubMed  Google Scholar 

  114. Baron JA, et al. Neoplastic and antineoplastic effects of beta‐carotene on colorectal adenoma recurrence: results of a randomized trial. J Natl Cancer Inst 2003;95(10):717–722.

    CAS  PubMed  Google Scholar 

  115. Slattery ML, et al. Associations between cigarette smoking, lifestyle factors, and microsatellite instability in colon tumors. J Natl Cancer Inst 2000;92(22):1831–1836.

    CAS  PubMed  Google Scholar 

  116. Giovannucci E, Colditz GA, Stampfer MJ. A meta‐analysis of cholecystectomy and risk of colorectal cancer. Gastroenterology 1993;105(1):130–141.

    CAS  PubMed  Google Scholar 

  117. Lagergren J, Ye W, Ekbom A. Intestinal cancer after cholecystectomy: is bile involved in carcinogenesis? Gastroenterology 2001;121(3):542–547.

    CAS  PubMed  Google Scholar 

  118. Schernhammer ES, et al. Cholecystectomy and the risk for developing colorectal cancer and distal colorectal adenomas. Br J Cancer 2003;88(1):79–83.

    CAS  PubMed  Google Scholar 

  119. Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta‐analysis. Gut 2001;48(4): 526–535.

    CAS  PubMed  Google Scholar 

  120. Ekbom A, et al. Ulcerative colitis and colorectal cancer. A population‐based study. N Engl J Med 1990;323(18):1228–1233.

    CAS  PubMed  Google Scholar 

  121. Sharan R, Schoen RE. Cancer in inflammatory bowel disease. An evidence‐based analysis and guide for physicians and patients. Gastroenterol Clin North Am 2002;31(1):237–254.

    PubMed  Google Scholar 

  122. Mpofu C, Watson AJ, Rhodes JM. Strategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease. Cochrane Database Syst Rev 2004(2):CD000279.

    Google Scholar 

  123. Loftus EV Jr. Does monitoring prevent cancer in inflammatory bowel disease? J Clin Gastroenterol 2003;36(5 suppl):S79–83; discussion S94–96.

    PubMed  Google Scholar 

  124. Eaden J, et al. Colorectal cancer prevention in ulcerative colitis: a case‐control study. Aliment Pharmacol Ther 2000;14(2): 145–153.

    CAS  PubMed  Google Scholar 

  125. Karlen P, et al. Is colonoscopic surveillance reducing colorectal cancer mortality in ulcerative colitis? A population based case control study. Gut 1998;42(5):711–714.

    CAS  PubMed  Google Scholar 

  126. Croog VJ, Ullman TA, Itzkowitz SH. Chemoprevention of colorectal cancer in ulcerative colitis. Int J Colorectal Dis 2003;18(5):392–400.

    PubMed  Google Scholar 

  127. Gillen CD, et al. Ulcerative colitis and Crohn's disease: a comparison of the colorectal cancer risk in extensive colitis. Gut 1994;35(11):1590–1592.

    CAS  PubMed  Google Scholar 

  128. Mellemkjaer L, et al. Crohn's disease and cancer risk (Denmark). Cancer Causes Control 2000;11(2):145–150.

    CAS  PubMed  Google Scholar 

  129. Johns LE, Houlston RS. A systematic review and meta‐analysis of familial colorectal cancer risk. Am J Gastroenterol 2001;96(10):2992–3003.

    CAS  PubMed  Google Scholar 

  130. Lynch HT, de la Chapelle A. Hereditary colorectal cancer. N Engl J Med 2003;348(10):919–932.

    CAS  PubMed  Google Scholar 

  131. Glanz K, et al. Underreporting of family history of colon cancer: correlates and implications. Cancer Epidemiol Biomarkers Prev 1999;8(7):635–639.

    CAS  PubMed  Google Scholar 

  132. Jacobs LA. Health beliefs of first‐degree relatives of individuals with colorectal cancer and participation in health maintenance visits: a population‐based survey. Cancer Nurs 2002;25(4):251–265.

    PubMed  Google Scholar 

  133. Tamai O, et al. Radiation‐associated rectal cancer: report of four cases. Dig Surg 1999;16(3):238–243.

    CAS  PubMed  Google Scholar 

  134. Brenner DJ, et al. Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer 2000;88(2):398–406.

    CAS  PubMed  Google Scholar 

  135. Shirouzu K, et al. Clinicopathologic characteristics of large bowel cancer developing after radiotherapy for uterine cervical cancer. Dis Colon Rectum 1994;37(12):1245–1249.

    CAS  PubMed  Google Scholar 

  136. Jao SW, et al. Colon and anorectal cancer after pelvic irradiation. Dis Colon Rectum 1987;30(12):953–958.

    CAS  PubMed  Google Scholar 

  137. Woodhouse CR. Guidelines for monitoring of patients with ureterosigmoidostomy. Gut 2002;51(suppl 5):V15–16.

    PubMed  Google Scholar 

  138. Husmann DA, Spence HM. Current status of tumor of the bowel following ureterosigmoidostomy: a review. J Urol 1990;144(3):607–610.

    CAS  PubMed  Google Scholar 

  139. Baris D, et al. Acromegaly and cancer risk: a cohort study in Sweden and Denmark. Cancer Causes Control 2002;13(5): 395–400.

    CAS  PubMed  Google Scholar 

  140. Orme SM, et al. Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom Acromegaly Study Group. J Clin Endocrinol Metab 1998;83(8):2730–2734.

    CAS  PubMed  Google Scholar 

  141. Jenkins PJ, Besser M. Clinical perspective: acromegaly and cancer—a problem. J Clin Endocrinol Metab 2001;86(7): 2935–2941.

    CAS  PubMed  Google Scholar 

  142. Jenkins PJ, et al. Insulin‐like growth factor I and the development of colorectal neoplasia in acromegaly. J Clin Endocrinol Metab 2000;85(9):3218–3221.

    CAS  PubMed  Google Scholar 

  143. Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000;100(1):57–70.

    CAS  PubMed  Google Scholar 

  144. Robbins DH, Itzkowitz SH. The molecular and genetic basis of colon cancer. Med Clin North Am 2002;86(6):1467–1495.

    CAS  PubMed  Google Scholar 

  145. Calvert PM, Frucht H. The genetics of colorectal cancer. Ann Intern Med 2002;137(7):603–612.

    CAS  PubMed  Google Scholar 

  146. Knudson AG Jr. Mutation and cancer: statistical study of retinoblastoma. Proc Natl Acad Sci USA 1971;68(4):820–823.

    PubMed  Google Scholar 

  147. Niell BL, et al. Genetic anthropology of the colorectal cancer‐susceptibility allele APC I1307K: evidence of genetic drift within the Ashkenazim. Am J Hum Genet 2003;73(6): 1250–1260.

    CAS  PubMed  Google Scholar 

  148. Rozen P, et al. Clinical and screening implications of the I1307K adenomatous polyposis coli gene variant in Israeli Ashkenazi Jews with familial colorectal neoplasia. Evidence for a founder effect. Cancer 2002;94(10):2561–2568.

    CAS  PubMed  Google Scholar 

  149. Frayling IM, et al. The APC variants I1307K and E1317Q are associated with colorectal tumors, but not always with a family history. Proc Natl Acad Sci USA 1998;95(18): 10722–10727.

    CAS  PubMed  Google Scholar 

  150. Takayama T, et al. Aberrant crypt foci of the colon as precursors of adenoma and cancer. N Engl J Med 1998;339(18): 1277–1284.

    CAS  PubMed  Google Scholar 

  151. Kirsch DG, Kastan MB. Tumor‐suppressor p53: implications for tumor development and prognosis. J Clin Oncol 1998;16(9):3158–3168.

    CAS  PubMed  Google Scholar 

  152. Birch JM, et al. Cancer phenotype correlates with constitutional TP53 genotype in families with the Li‐Fraumeni syndrome. Oncogene 1998;17(9):1061–1068.

    CAS  PubMed  Google Scholar 

  153. Rosati G, et al. Thymidylate synthase expression, p53, bcl‐2, Ki‐67 and p27 in colorectal cancer: relationships with tumor recurrence and survival. Tumour Biol 2004;25(5–6):258–263.

    CAS  PubMed  Google Scholar 

  154. Resnick MB, et al. Epidermal growth factor receptor, c‐MET, beta‐catenin, and p53 expression as prognostic indicators in stage II colon cancer: a tissue microarray study. Clin Cancer Res 2004;10(9):3069–3075.

    CAS  PubMed  Google Scholar 

  155. Iacopetta B. TP53 mutation in colorectal cancer. Hum Mutat 2003;21(3):271–276.

    CAS  PubMed  Google Scholar 

  156. Fearon ER, et al. Identification of a chromosome 18q gene that is altered in colorectal cancers. Science 1990;247(4938): 49–56.

    CAS  PubMed  Google Scholar 

  157. Shibata D, et al. The DCC protein and prognosis in colorectal cancer. N Engl J Med 1996;335(23):1727–1732.

    CAS  PubMed  Google Scholar 

  158. Umar A, et al. Revised Bethesda guidelines for hereditary nonpolyposis colorectal cancer (Lynch syndrome) and microsatellite instability. J Natl Cancer Inst 2004;96(4):261–268.

    CAS  PubMed  Google Scholar 

  159. Ward R, et al. Microsatellite instability and the clinicopathological features of sporadic colorectal cancer. Gut 2001;48(6): 821–829.

    CAS  PubMed  Google Scholar 

  160. Smyrk TC, et al. Tumor‐infiltrating lymphocytes are a marker for microsatellite instability in colorectal carcinoma. Cancer 2001;91(12):2417–2422.

    CAS  PubMed  Google Scholar 

  161. Jass JR, et al. Morphology of sporadic colorectal cancer with DNA replication errors. Gut 1998;42(5):673–679.

    CAS  PubMed  Google Scholar 

  162. Gryfe R, et al. Tumor microsatellite instability and clinical outcome in young patients with colorectal cancer. N Engl J Med 2000;342(2):69–77.

    CAS  PubMed  Google Scholar 

  163. Ribic CM, et al. Tumor microsatellite‐instability status as a predictor of benefit from fluorouracil‐based adjuvant chemotherapy for colon cancer. N Engl J Med 2003;349(3):247–257.

    CAS  PubMed  Google Scholar 

  164. Peltomaki P. Deficient DNA mismatch repair: a common etiologic factor for colon cancer. Hum Mol Genet 2001;10(7): 735–740.

    CAS  PubMed  Google Scholar 

  165. Lynch HT, de la Chapelle A. Genetic susceptibility to non‐polyposis colorectal cancer. J Med Genet 1999;36(11):801–818.

    CAS  PubMed  Google Scholar 

  166. Liu B, et al. Analysis of mismatch repair genes in hereditary non‐polyposis colorectal cancer patients. Nat Med 1996;2(2):169–174.

    CAS  PubMed  Google Scholar 

  167. Cunningham JM, et al. Hypermethylation of the hMLH1 promoter in colon cancer with microsatellite instability. Cancer Res 1998;58(15):3455–3460.

    CAS  PubMed  Google Scholar 

  168. Toyota M, et al. Distinct genetic profiles in colorectal tumors with or without the CpG island methylator phenotype. Proc Natl Acad Sci USA 2000;97(2):710–715.

    CAS  PubMed  Google Scholar 

  169. Kakar S, et al. Frequency of loss of hMLH1 expression in colorectal carcinoma increases with advancing age. Cancer 2003;97(6):1421–1427.

    CAS  PubMed  Google Scholar 

  170. Al‐Tassan N, et al. Inherited variants of MYH associated with somatic G:C−>T:A mutations in colorectal tumors. Nat Genet 2002;30(2):227–232.

    PubMed  Google Scholar 

  171. Sieber OM, et al. Multiple colorectal adenomas, classic adenomatous polyposis, and germ‐line mutations in MYH. N Engl J Med 2003;348(9):791–799.

    PubMed  Google Scholar 

  172. Vogelstein B, et al. Genetic alterations during colorectal‐tumor development. N Engl J Med 1988;319(9):525–532.

    CAS  PubMed  Google Scholar 

  173. Bird RP, Good CK. The significance of aberrant crypt foci in understanding the pathogenesis of colon cancer. Toxicol Lett 2000;112–113:395–402.

    PubMed  Google Scholar 

  174. Lengauer C, Kinzler KW, Vogelstein B. Genetic instability in colorectal cancers. Nature 1997;386(6625):623–627.

    CAS  PubMed  Google Scholar 

  175. Grady WM. Genomic instability and colon cancer. Cancer Metastasis Rev 2004;23(1–2):11–27.

    CAS  PubMed  Google Scholar 

  176. Higuchi T, Jass JR. My approach to serrated polyps of the colorectum. J Clin Pathol 2004;57(7):682–686.

    CAS  PubMed  Google Scholar 

  177. Jass JR. Pathogenesis of colorectal cancer. Surg Clin North Am 2002;82(5):891–904.

    PubMed  Google Scholar 

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Baxter, N.N., Guillem, J.G. (2007). Colorectal Cancer: Epidemiology, Etiology, and Molecular Basis. In: Wolff, B.G., et al. The ASCRS Textbook of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-36374-5_23

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