Insights into Early Neoplasia in the Human Colon

Colorectal cancer (CRC) is the second leading cause of cancer related death in the United States. CRC is believed to develop through a multistage adenoma-carcinoma sequence, where polyps represent an intermediate, precursor lesion to advanced cancer. Recent success in CRC prevention has been largely attributed to the interruption of this process through the widespread implementation of endoscopic polypectomy. Although the overall rates of CRC have declined, there has been an observable shift in the distribution of CRCs to the proximal colon, in particular among patients who develop \u27interval\u27 CRC, cancers that arise between negative screening colonoscopies. Novel strategies and biomarkers are needed to further reduce overall rates of CRC and identify individuals at increased risk for proximal adenomas and CRC. By studying polyps and aberrant crypt foci (ACF), the earliest detectable lesion in the human colon, we will be able to gain a better understanding of the mechanisms and epidemiological risk factors of early proximal colon carcinogenesis