Mutagens in human faeces. Are they relevant to cancer of the large bowel?

1. Mutagenic activity has been detected in faecal extracts, prepared by a number of methods, from donors living under widely differing geographical, cultural and dietary circumstances. Faecal extracts cause point mutations in bacteria and chromosomal damage in cultured mammalian cells. 2. The claims that nitroso compounds are present in human faeces have been retracted, and the chemical nature of faecal mutagens is still unknown. Indirect evidence suggests the presence of several classes of mutagen. 3. The use of different methods of mutation assay gives conflicting estimates of the proportion of people who excrete mutagenic faeces. There is wide variation in mutagenic activity between different stool samples from one person, and between different stool samples from different people. There is conflicting evidence for inhibition or enhancement of the mutagenicity of reference mutagens by faecal extracts. The effects of air oxidation on the mutagenicity of faecal extracts have not been investigated in detail. 4. It has been claimed that the proportion of people excreting mutagenic faeces is higher in groups representing populations at high risk of large-bowel cancer than in groups at low risk of large-bowel cancer. For the reasons given in paragraph 3, these claims must be regarded as premature. 5. The part played by faecal mutagens in the aetiology of large-bowel cancer has yet to be determined.