Colorectal cancer: molecules and populations

Area of Science:

• Oncology
• Molecular Biology
• Epidemiology

Background:

• Colorectal cancer (CRC) development is influenced by a complex interplay of genetic and environmental factors.
• Epidemiological studies have identified numerous risk and protective factors for colorectal neoplasia.

Purpose of the Study:

• To review the epidemiology and molecular biology of colorectal cancer, focusing on their interrelationship.
• To explore how environmental exposures and host susceptibilities interact with molecular pathways in CRC.

Main Methods:

• Literature review of epidemiological data and molecular biology research on colorectal cancer.
• Analysis of established and suggested molecular pathways, including APC-beta-catenin-Tcf and DNA mismatch repair.
• Examination of the influence of environmental factors and genetic polymorphisms on these pathways.

Main Results:

• Key risk factors include family history, meat consumption, smoking, and alcohol; protective factors include vegetables, NSAIDs, HRT, and physical activity.
• Major molecular pathways include APC-beta-catenin-Tcf and DNA mismatch repair, relevant in both inherited and sporadic CRC.
• Environmental exposures like NSAIDs, meat, and tobacco smoke interact with molecular pathways; folate and heterocyclic amine metabolism can be influenced by gene polymorphisms.

Conclusions:

• Understanding the molecular underpinnings of CRC, influenced by environmental and genetic factors, is crucial for developing effective screening, treatment, and prevention strategies.
• Further research into the obscure roles of factors like physical activity and host metabolic states can refine CRC management.