Abstract
Colorectal cancer (CRC) is a common malignancy. It arises from benign neoplasms and evolves into adenocarcinomas through a stepwise histological progression sequence, proceeding from either adenomas or hyperplastic polyps/serrated adenomas. Genetic alterations have been associated with specific steps in this adenoma-carcinoma sequence and are believed to drive the histological progression of CRC. Recently, epigenetic alterations (especially DNA methylation) have been shown to occur in colon polyps and CRC. The aberrant methylation of genes appears to act together with genetic alterations to drive the initiation and progression of colon polyps to CRC.DNA methylation changes have been recognized as one of the most common molecular alterations in human tumors, including CRC. Because of the ubiquity of DNA methylation changes and the ability to detect methylated DNA in several body fluids (blood, stool), this specifically altered DNA may serve, on the one hand, as a possible new screening marker for CRC and, on the other hand, as a tool for therapy monitoring in patients having had neoplastic disease of the colorectum.As many CRC patients present with advanced disease, early detection seems to be one of the most important approaches to reduce mortality. Therefore, an effective screening test would have substantial clinical benefits. Furthermore, early detection of progression of disease in patients having had CRC permits immediate commencement of specific treatment regimens (e.g. curative resection of liver and lung metastases) and probably longer survival and better quality of life.
Highlights
Colorectal cancer (CRC) is a common malignancy
Most CRCs appear in the rectum (38%) or sigmoid colon (29%) and around two-thirds of CRCs fall within the reach of sigmoidoscopy [13]
Clinicians should determine an individual patient’s risk status well before the earliest potential initiation of screening (typically around age 20 years, but earlier if there is a family history of familial adenomatous polyposis (FAP)), and any predisposition to CRC should prompt further efforts to identify and define the specific condition associated with increased risk
Summary
Colorectal cancer (CRC) is the third most common malignant neoplasm worldwide [1]. In 2005, the American Cancer Society estimated 145290 new cases of and 56290 deaths from CRC in the United States. CRC is the third most common malignancy and the third-leading cause of cancer death in women and men in the United States. The lifetime incidence of CRC among women and men at average risk is sufficiently high at 6%, or 1 in 18 [4]. Because of the frequency of the disease, demonstrated slow growth of primary lesions and better survival of patients with early-stage lesions, CRC is a suit-. Most CRCs appear in the rectum (38%) or sigmoid colon (29%) and around two-thirds of CRCs fall within the reach of sigmoidoscopy [13]
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