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Colon cancer has a well defined, multistep evolution defined both by histology and by molecular events. Colon cancer occurs both in an hereditary pattern secondary to germline mutations and, more commonly, in a sporadic pattern secondary to somatic mutations. The molecular lesions of colon cancer appear years before invasive cancer. The cells lining the colon are bathed in a lifelong effluent of bacteria and breakdown products of digestion. Our knowledge of carcinogenesis agrees with epidemiologic evidence that suggests a high-fiber, lower-fat diet would decrease the incidence of colon cancer. Inert fiber moves stool through the colon faster, decreasing exposure of the lining cells to carcinogens. Less fat and more antioxidants in our diets may further shift the rate of carcinogenesis. (Recall the steps in Figure 5.2.)
KeywordsColon Cancer Germline Mutation Familial Adenomatous Polyposis Colon Polyp Villous Adenoma
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