[Clinically relevant, gender-specific differences in colorectal carcinoma (CRC)].

Area of Science:

• Oncology
• Endocrinology
• Genetics

Context:

• Colorectal cancer (CRC) incidence is higher in men, unexplained by common risk factors.
• Estrogen's role in CRC pathogenesis is suggested as protective, potentially via estrogen receptor beta.
• Tumor location in CRC varies by age and gender, with postmenopausal women showing a shift to right-sided cancers.

Purpose:

• To explore the unclear role of estrogen in colorectal cancer carcinogenesis.
• To investigate gender-specific differences in CRC tumor localization and treatment response.
• To highlight the need for gender-specific considerations in CRC clinical trials.

Summary:

• Estrogen may protect against colon cancer, particularly in premenopausal women, and its receptor expression decreases in cancerous tissue.
• Gender influences CRC tumor location, with postmenopausal women developing more right-sided tumors, potentially linked to microsatellite-high status.
• Women may experience increased toxicity to 5-FU chemotherapy and poorer response to anti-EGFR therapy for right-sided tumors compared to men.

Impact:

• Understanding estrogen's role could lead to novel chemopreventive or therapeutic strategies for colorectal cancer.
• Recognizing gender-specific differences in CRC can optimize treatment selection and improve patient outcomes.
• Incorporating gender as a variable in future randomized trials is crucial for advancing colorectal cancer care.