title: Colorectal carcinogenesis--update and perspectives.
abstract: Colorectal cancer (CRC) is a very common malignancy in the Western World and despite advances in surgery, chemotherapy and screening, it is still the second leading cause of cancer deaths in this part of the world. Numerous factors are found important in the development of CRC including colonocyte metabolism, high risk luminal environment, inflammation, as well as lifestyle factors such as diet, tobacco, and alcohol consumption. In recent years focus has turned towards the genetics and molecular biology of CRC and several interesting and promising correlations and pathways have been discovered. The major genetic pathways of CRC are the Chromosome Instability Pathway representing the pathway of sporadic CRC through the K-ras, APC, and P53 mutations, and the Microsatellite Instability Pathway representing the pathway of hereditary non-polyposis colon cancer through mutations in mismatch repair genes. To identify early cancers, screening programs have been initiated, and the leading strategy has been the use of faecal occult blood testing followed by colonoscopy in positive cases. Regarding the treatment of colorectal cancer, significant advances have been made in the recent decade. The molecular targets of CRC include at least two important cell surface receptors: the epidermal growth factor receptor and the vascular endothelial growth factor receptor. The genetic and molecular knowledge of CRC has widen the scientific and clinical perspectives of diagnosing and treatment. However, despite significant advances in the understanding and treatment of CRC, results from targeted therapy are still not convincing. Future studies will determine the role for this new treatment modality.
authors.affiliation: Hans Raskov, Speciallægecentret ved Diakonissestiftelsen, 2000 Frederiksberg, Denmark.
authors.forename: Hans
authors.initials: H
authors.lastname: Raskov
authors.affiliation: Hans Raskov, Speciallægecentret ved Diakonissestiftelsen, 2000 Frederiksberg, Denmark.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Pommergaard
authors.affiliation: Hans Raskov, Speciallægecentret ved Diakonissestiftelsen, 2000 Frederiksberg, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Burcharth
authors.affiliation: Hans Raskov, Speciallægecentret ved Diakonissestiftelsen, 2000 Frederiksberg, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control; D000818:Animals; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D003106:Colon / Q000378:metabolism / Q000473:pathology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D004032:Diet / Q000009:adverse effects; D020022:Genetic Predisposition to Disease; D006801:Humans; D008019:Life Style; D053842:Microsatellite Instability; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D000074606:Smoking Prevention
chemical_list: D014408:Biomarkers, Tumor
keywords: Colorectal carcinogenesis; Diet; Genetics; Inflammation; Microbiology; Microbiome; Risk factors