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A Genetically Engineered Mouse Model of Sporadic Colorectal Cancer
Published on: July 6, 2017
The adenoma hunt in colorectal cancer screening: defining the target
Anke H Sillars-Hardebol1, Beatriz Carvalho, Manon van Engeland
1Department of Pathology, VU University Medical Centre, Amsterdam, The Netherlands.
Abstract:
Colorectal adenomas are precursor lesions of colorectal cancer. Different biological and metabolic processes contribute to adenomagenesis. Subsequent progression to carcinoma occurs in only about 5% of the cases. Detection and removal of all adenomas would reduce CRC incidence and mortality, but at the cost of major over-treatment. Classical morphological characteristics fail to accurately discriminate between adenomas that will become malignant and those that will not. Understanding the biology of cancer development will help to better characterize adenomas at high risk of progression, and subsequently establish triage tests that allow to safely reserve colonoscopy only for individuals at high probability of having truly high-risk colorectal adenomas. Screening tests based on genomic changes that affect relevant biological and metabolic processes hold most promise in this respect.
Insights
Colorectal adenomas can lead to cancer, but most do not progress. Identifying high-risk adenomas through genomic screening could prevent unnecessary colonoscopies and over-treatment.
Area of Science:
- Gastroenterology
- Oncology
- Molecular Biology
Background:
- Colorectal adenomas are precancerous lesions.
- Only 5% of adenomas progress to colorectal cancer (CRC).
- Current methods cannot reliably distinguish between high-risk and low-risk adenomas.
Purpose of the Study:
- To understand the biological processes driving adenoma progression.
- To develop better methods for identifying high-risk colorectal adenomas.
- To reduce CRC incidence and mortality while minimizing over-treatment.
Main Methods:
- Analysis of biological and metabolic processes in adenomagenesis.
- Investigating genomic changes associated with adenoma progression.
- Exploring potential triage tests for colorectal adenomas.
Main Results:
- Biological and metabolic pathways are key to adenoma development.
- Genomic alterations are promising markers for adenoma risk stratification.
- Improved characterization of adenomas can guide clinical management.
Conclusions:
- Understanding adenoma biology is crucial for risk assessment.
- Genomic screening tests offer a promising approach for identifying high-risk colorectal adenomas.
- Targeted colonoscopy based on risk stratification can optimize patient care and reduce overtreatment.
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