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The Molecular Pathogenesis of Colorectal Cancer and Its Potential Application to Colorectal Cancer Screening

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Abstract

Introduction

Advances in our understanding of the molecular genetics and epigenetics of colorectal cancer have led to novel insights into the pathogenesis of this common cancer. These advances have revealed that there are molecular subtypes of colon polyps and colon cancer and that these molecular subclasses have unique and discrete clinical and pathological features. Although the molecular characterization of these subgroups of colorectal polyps and cancer is only partially understood at this time, it does appear likely that classifying colon polyps and cancers based on their genomic instability and/or epigenomic instability status will eventually be useful for informing approaches for the prevention and early detection of colon polyps and colorectal cancer.

Conclusions

In this review, we will discuss our current understanding of the molecular pathogenesis of the polyp to cancer sequence and the potential to use this information to direct screening and prevention programs.

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Acknowledgments

Work on this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Numbers P30CA15704, UO1CA152756, 5U01HG006507, U54CA143862, and P01CA077852 (W.M.G.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Support for this work was also provided by a Burroughs Wellcome Fund Translational Research Award for Clinician Scientist (W.M.G.). We wish to thank Michael Luo for helpful suggestions.

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Authors and Affiliations

  1. Department of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Sanford D. Markowitz

  2. Clinical Research Division, Fred Hutchison Cancer Research Center, 1100 Fairview Avenue N., D4-100, Seattle, WA, 98109, USA

    William M. Grady

  3. Department of Medicine, University of Washington, Seattle, WA, USA

    William M. Grady

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Grady, W.M., Markowitz, S.D. The Molecular Pathogenesis of Colorectal Cancer and Its Potential Application to Colorectal Cancer Screening. Dig Dis Sci 60, 762–772 (2015). https://doi.org/10.1007/s10620-014-3444-4

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  • DOI: https://doi.org/10.1007/s10620-014-3444-4

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