Analysis of total and individual fecal neutral steroids in different groups of intestinal pathology from 105 patients was performed to investigate a relationship between neutral steroid concentration and malignant potentiality of colon cells. The fecal concentration of total neutral steroids was significantly higher in patients with colon cancer (57.3 +/- 2.4 mmol/kg of wet feces) and patients with malignant degenerative polyps at Stage I or II (49.5 +/- 2.9) compared with controls (36.9 +/- 3.5) as well as patients with adenomatous polyps (22.4 +/- 2.0). Moreover, a significant correlation was found between total neutral steroid concentrations and coprostanol concentrations in patients with colon cancer (r = 0.928) and in patients with malignant polyps (r = 0.915). Coprostanol results only from the biohydrogenation of delta 5-3 beta-OH steroids by anerobic bacteria because the analysis of a malignant colon tumor in comparison with a healthy colon wall showed that cholesterol is the only steroid included in membrane cells, and that the incubation of Clostridium or Bacteroides with delta 5-3 beta-OH steroids, such as cholesterol (steroid of animal origin) or beta-sitosterol (steroid of plant origin) converts these steroids into coprostanol at a level of efficiency greater than 45%. The findings suggest that high levels of coprostanol reflecting a high growth of anerobic bacteria through the gut are related to the malignant potentiality of colon cells. The screening of neutral fecal steroids should provide a valuable parameter for predicting the malignancy of colon cells.