Colorectal cancer causes: Difference between revisions

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==Overview==
==Overview==
The causes and the risk factors for colorectal carcinoma are similar. There are both genetic and environmental causes of colorectal carcinoma (CRC). Some of the genetic causes are familial adenomatous polyposis and hereditary non-polyposis colorectal cancer. Some environmental causes are personal/family history, history of inflammatory bowel disease, diet, alcohol, cigarette smoking, and abdominal radiation.
There are both genetic and environmental causes of colorectal carcinoma (CRC). Some of the genetic causes are familial adenomatous polyposis and hereditary non-polyposis colorectal cancer. The remaining majority of colorectal cancers develop from environmental causes.


==Colorectal Cancer Causes==
==Colorectal Cancer Causes==
The causes and the risk factors for colorectal carcinoma are similar. There are both genetic and environmental causes of colorectal carcinoma<ref name="pmid20420944">{{cite journal| author=Chan AT, Giovannucci EL| title=Primary prevention of colorectal cancer. | journal=Gastroenterology | year= 2010 | volume= 138 | issue= 6 | pages= 2029-2043.e10 |pmid=20420944 | doi=10.1053/j.gastro.2010.01.057 | pmc=PMC2947820 |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20420944  }}</ref>. FAP and HNPCC are the most common causes of CRC, but together these two conditions account for only about 5 percent of CRC<ref name="pmid7598472">{{cite journal| author=Burt RW, DiSario JA, Cannon-Albright L| title=Genetics of colon cancer: impact of inheritance on colon cancer risk. | journal=Annu Rev Med | year= 1995 | volume= 46 |issue=  | pages= 371-9 | pmid=7598472 | doi=10.1146/annurev.med.46.1.371 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7598472  }} </ref>.
There are both genetic and environmental causes of colorectal carcinoma<ref name="pmid20420944">{{cite journal| author=Chan AT, Giovannucci EL| title=Primary prevention of colorectal cancer. | journal=Gastroenterology | year= 2010 | volume= 138 | issue= 6 | pages= 2029-2043.e10 |pmid=20420944 | doi=10.1053/j.gastro.2010.01.057 | pmc=PMC2947820 |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20420944  }}</ref>. FAP and HNPCC are the most common causes of CRC, but together these two conditions account for only about 5 percent of CRC<ref name="pmid7598472">{{cite journal| author=Burt RW, DiSario JA, Cannon-Albright L| title=Genetics of colon cancer: impact of inheritance on colon cancer risk. | journal=Annu Rev Med | year= 1995 | volume= 46 |issue=  | pages= 371-9 | pmid=7598472 | doi=10.1146/annurev.med.46.1.371 | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7598472  }} </ref>.


The table below lists the genetic causes for colorectal carcinoma:
The table below lists the genetic causes for colorectal carcinoma:
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| '''Familial Adenomatous Polyposis (FAP)'''||AD inheritance; other variants include [[Gardner's syndrome]], Turcot's syndrome and attenuated adenomatous polyposis coli; caused by germlines mutations in the APC gene<ref name="pmid598472">{{cite journal| author=Mazur IA| title=[Synthesis of imidazopyrimidines and imidazoquinazolines with a common nitrogen atom]. | journal=Farm Zh | year= 1977 | volume=  | issue= 6 |pages= 37-41 | pmid=598472 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=598472}}</ref>; colonic cancer occurs in 90% of untreated individuals around 45 years
| '''Familial Adenomatous Polyposis (FAP)'''||AD inheritance; other variants include [[Gardner's syndrome]], Turcot's syndrome and attenuated adenomatous polyposis coli; caused by germlines mutations in the APC gene<ref name="pmid598472">{{cite journal| author=Mazur IA| title=[Synthesis of imidazopyrimidines and imidazoquinazolines with a common nitrogen atom]. | journal=Farm Zh | year= 1977 | volume=  | issue= 6 |pages= 37-41 | pmid=598472 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=598472}}</ref>; colonic cancer occurs in 90% of untreated individuals around 45 years
To view Gardner's syndrome, Turcot's syndrome and attenuated adenomatous polyposis coli , click [[Hereditary nonpolyposis colorectal cancer classification|'''here''']]<br>


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The table below lists the environmental causes for colorectal carcinoma:
The remaining majority of colorectal cancers develop from environmental causes.
{| {{table}}
| align="center" style="background:#f0f0f0;"|'''Environmental Cause'''
 
| align="center" style="background:#f0f0f0;"|'''Description'''
 
|-
 
| '''Ulcerative Colitis'''||The increase in risk begins about 8 to 10 years after the initial diagnosis of [[pancolitis]]  and at 15 to 20 years if the colitis is limited to the left colon; by the fourth decade of disease it reaches as high as 30% in patients with [[pancolitis]]; [[pseudopolyps]] and [[strictures]] may increase the risk<ref name="pmid2215606">{{cite journal| author=Ekbom A, Helmick C, Zack M, Adami HO| title=Ulcerative colitis and colorectal cancer. A population-based study. | journal=N Engl J Med | year= 1990 | volume= 323 | issue= 18 | pages= 1228-33 | pmid=2215606 | doi=10.1056/NEJM199011013231802 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2215606  }} </ref>
 
|-
 
| '''Crohn's Disease'''||There is an increased risk if 1/3 or more of the colonic mucosa is involved
 
|-
 
| '''Abdominal Radiation'''||Adult survivors of childhood malignancy who received [[abdominal]] radiation are at significant risk<ref name="pmid22665813">{{cite journal| author=Henderson TO, Oeffinger KC, Whitton J, Leisenring W, Neglia J, Meadows A et al.| title=Secondary gastrointestinal cancer in childhood cancer survivors: a cohort study. | journal=Ann Intern Med | year= 2012 | volume= 156 | issue= 11 | pages= 757-66, W-260 | pmid=22665813 | doi=10.7326/0003-4819-156-11-201206050-00002 | pmc=PMC3554254 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22665813  }} </ref>
 
|-
 
| '''Diabetes Mellitus and Insulin Resistance'''||Although it is not clear why but one possible explanation linking diabetes to CRC is [[hyperinsulinemia]]  insulin is an important growth factor for colonic mucosal cells and stimulates colonic [[tumor]] cells<ref name="pmid7749056">{{cite journal| author=Giovannucci E| title=Insulin and colon cancer. | journal=Cancer Causes Control | year= 1995 | volume= 6 | issue= 2 | pages= 164-79 | pmid=7749056 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7749056  }} </ref>
 
|-
 
| '''Alcohol'''||The elevated risk may be related to interference of [[folate]] absorption by [[alcohol]] and decreased folate intake<ref name="pmid12588695">{{cite journal| author=Harnack L, Jacobs DR, Nicodemus K, Lazovich D, Anderson K, Folsom AR| title=Relationship of folate, vitamin B-6, vitamin B-12, and methionine intake to incidence of colorectal cancers. | journal=Nutr Cancer | year= 2002 | volume= 43 | issue= 2 | pages= 152-8 | pmid=12588695 | doi=10.1207/S15327914NC432_5 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12588695  }} </ref>
 
|-
 
| '''Obesity'''||It was reported that each 5 kg/m2 increase in BMI was associated with a 24 percent increased incidence of both colon and rectal cancer in men, and a 9 percent higher incidence of colon cancer in women<ref name="pmid12588695">{{cite journal| author=Harnack L, Jacobs DR, Nicodemus K, Lazovich D, Anderson K, Folsom AR| title=Relationship of folate, vitamin B-6, vitamin B-12, and methionine intake to incidence of colorectal cancers. | journal=Nutr Cancer | year= 2002 | volume= 43 | issue= 2 | pages= 152-8 | pmid=12588695 | doi=10.1207/S15327914NC432_5 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12588695  }} </ref>
 
|-
 
| '''Cigarette Smoking'''||It was reported that the risk of developing CRC was increased among cigarette smokers compared to those who never smoked; for both incidence and mortality, the association was stronger for cancer of the [[rectum]] than the colon<ref name="pmid19088354">{{cite journal| author=Botteri E, Iodice S, Bagnardi V, Raimondi S, Lowenfels AB, Maisonneuve P| title=Smoking and colorectal cancer: a meta-analysis. | journal=JAMA | year= 2008 | volume= 300 | issue= 23 | pages= 2765-78 | pmid=19088354 | doi=10.1001/jama.2008.839 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19088354  }} </ref>
 
|-
 
| '''Uretercolic Anastomoses'''||There is increased risk of neoplasia in close proximity to the ureteric [[stoma]]<ref name="pmid7104616">{{cite journal| author=Stewart M, Macrae FA, Williams CB| title=Neoplasia and ureterosigmoidostomy: a colonoscopy survey. | journal=Br J Surg | year= 1982 | volume= 69 | issue= 7 | pages= 414-6 | pmid=7104616 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7104616  }} </ref>
 
|-
 
| '''Diet'''||Long-term consumption of red meat or processed meats, diets low in vegetables and high in fats may be associated with an increased risk of CRC{<ref name="pmid15644544">{{cite journal| author=Chao A, Thun MJ, Connell CJ, McCullough ML, Jacobs EJ, Flanders WD et al.| title=Meat consumption and risk of colorectal cancer. | journal=JAMA | year= 2005 | volume= 293 | issue= 2 | pages= 172-82 | pmid=15644544 | doi=10.1001/jama.293.2.172 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15644544  }} </ref><ref name="pmid10378216">{{cite journal| author=Glade MJ| title=Food, nutrition, and the prevention of cancer: a global perspective. American Institute for Cancer Research/World Cancer Research Fund, American Institute for Cancer Research, 1997. | journal=Nutrition | year= 1999 | volume= 15 | issue= 6 | pages= 523-6 | pmid=10378216 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10378216  }} </ref>
 
|-
 
| '''Sedentary Lifestyle'''||Regular exercise stimulates peristalsis, thereby decreasing transit time for [[carcinogenic]] substances in the colon<ref name="pmid24569462">{{cite journal| author=Lynch BM, Boyle T| title=Distinguishing sedentary from inactive: implications for meta-analyses. | journal=Br J Cancer | year= 2014 | volume= 111 | issue= 11 | pages= 2202-3 | pmid=24569462 | doi=10.1038/bjc.2014.106 | pmc=PMC4260011 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24569462  }} </ref>
|}


==References==
==References==

Revision as of 15:39, 16 July 2015

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To view the causes of familial adenomatous polyposis (FAP), click here
To view the causes of hereditary nonpolyposis colorectal cancer (HNPCC), click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.

Overview

There are both genetic and environmental causes of colorectal carcinoma (CRC). Some of the genetic causes are familial adenomatous polyposis and hereditary non-polyposis colorectal cancer. The remaining majority of colorectal cancers develop from environmental causes.

Colorectal Cancer Causes

There are both genetic and environmental causes of colorectal carcinoma[1]. FAP and HNPCC are the most common causes of CRC, but together these two conditions account for only about 5 percent of CRC[2].

The table below lists the genetic causes for colorectal carcinoma:

Genetic Cause Description
Familial Adenomatous Polyposis (FAP) AD inheritance; other variants include Gardner's syndrome, Turcot's syndrome and attenuated adenomatous polyposis coli; caused by germlines mutations in the APC gene[3]; colonic cancer occurs in 90% of untreated individuals around 45 years

To view Gardner's syndrome, Turcot's syndrome and attenuated adenomatous polyposis coli , click here


MUTYH-associated Polyposis (MAP) AR inheritance; caused by biallelic germline mutations in the base excision repair gene mutY homolog (MYH or MUTYH)
Lynch Syndrome AKA Hereditary Non-polyposis Colorectal Cancer (HNPCC) AD inheritance; caused by a defect in one of the mismatch repair genes, most commonly hMLH1, hMSH2, hMSH6, or PMS2; the mean age at initial cancer diagnosis is around 48 years[4]

The remaining majority of colorectal cancers develop from environmental causes.

References

  1. ↑ Chan AT, Giovannucci EL (2010). "Primary prevention of colorectal cancer". Gastroenterology. 138 (6): 2029–2043.e10. doi:10.1053/j.gastro.2010.01.057. PMC 2947820. PMID 20420944.
  2. ↑ Burt RW, DiSario JA, Cannon-Albright L (1995). "Genetics of colon cancer: impact of inheritance on colon cancer risk". Annu Rev Med. 46: 371–9. doi:10.1146/annurev.med.46.1.371. PMID 7598472.
  3. ↑ Mazur IA (1977). "[Synthesis of imidazopyrimidines and imidazoquinazolines with a common nitrogen atom]". Farm Zh (6): 37–41. PMID 598472.
  4. ↑ Parry S, Win AK, Parry B, Macrae FA, Gurrin LC, Church JM; et al. (2011). "Metachronous colorectal cancer risk for mismatch repair gene mutation carriers: the advantage of more extensive colon surgery". Gut. 60 (7): 950–7. doi:10.1136/gut.2010.228056. PMC 3848416. PMID 21193451.


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