Comment from the EditorOne Colon Lumen but Two Organs
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2023, Pathology Research and PracticeAssociation Between Metabolic Syndrome and the Risk of Colorectal Cancer Diagnosed Before Age 50 Years According to Tumor Location
2022, GastroenterologyCitation Excerpt :CRCs located at different anatomic subsites may have distinct clinical and molecular characteristics, suggesting differences in risk factors and carcinogenetic mechanisms by tumor location in the colon.39,41,42 Although the underlying biological mechanism for the development of CRCs, depending on tumor location, remains poorly understood, a possible hypothesis is that the bile-acid concentration, metabolite presence, pH level, and microbial environment vary along the colon and rectum.43 Molecular subtypes of CRC are also disproportionally distributed across the colon and rectum.
Treatment sequencing of metastatic colorectal cancer based on primary tumor location
2021, Seminars in OncologyCitation Excerpt :Treatment of advanced colorectal cancer is based on a multidisciplinary assessment of a patient's performance status, potential for resection of metastatic disease, and predictive biomarkers for response to epidermal growth factor receptor (EGFR) targeting agents. Recent data have highlighted the fact that colorectal cancer is a heterogeneous disease with various clinical, molecular, and embryological differences demonstrated in tumors arising from different regions of the colon [1-4]. Right-sided colon cancer is defined as cancer of the cecum and ascending colon up to the hepatic flexure, while left-sided colon cancer comprises tumors in the splenic flexure and cancer in regions distal to the splenic flexure, including the rectum.
Racial and ethnic disparities in colorectal cancer incidence and mortality
2021, Advances in Cancer ResearchCitation Excerpt :Non-invasive screening tests such as fecal immunochemical test (FIT) and multi-target stool DNA test (mt-sDNA) may help identify CRCs (and much less so adenomas) anywhere in the colon, whereas flexible sigmoidoscopy is limited to the terminal 60 cm of the colorectum (Carethers, 2020; Rex et al., 2017). Moreover, proximal cancers and adenomas (orad to the colonic splenic flexure) may have a different genetic makeup, such as CpG island methylator phenotype (CIMP), microsatellite instability-high (MSI-H) and show different biological behavior (such as flat superficial spreading morphology, rapid growth, serrated pattern) and grow to larger sizes without colonic obstruction in the liquid stool containing proximal colon (Carethers, 2011). The majority of data for anatomical CRC site in regards to race/ethnicity is for Black Americans.
Epidemiology and Mechanisms of the Increasing Incidence of Colon and Rectal Cancers in Young Adults
2020, GastroenterologyCitation Excerpt :These might affect susceptibility to risk factors and create better or worse conditions for carcinogenesis.105 There are different embryonic origins of the proximal (midgut) colon and distal (hindgut) colorectum,106 which might also affect carcinogenesis. For example, the right colon is exposed to bile acids and other metabolites that have escaped the small intestine, and in a form that the left colon is not, after bacterial action on metabolites.
Funding Supported by NIH grant DK067287 and the San Diego State University–University of California San Diego Comprehensive Cancer Center Partnership (CA132379 and CA132384).