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World J Gastroenterol. 2014 May 28;20(20):6055-72. doi: 10.3748/wjg.v20.i20.6055.

Epidemiological transition of colorectal cancer in developing countries: environmental factors, molecular pathways, and opportunities for prevention.

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Faraz Bishehsari, Division of Gastroenterology, Robert H Lurie Comprehensive Cancer Center, Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, United States.


Colorectal cancer (CRC) is one of the leading causes of cancer and cancer-related mortality worldwide. The disease has been traditionally a major health problem in industrial countries, however the CRC rates are increasing in the developing countries that are undergoing economic growth. Several environmental risk factors, mainly changes in diet and life style, have been suggested to underlie the rise of CRC in these populations. Diet and lifestyle impinge on nuclear receptors, on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis. In this respect, the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations. The data from these studies may have important implications for the global prevention and treatment of CRC.


Colorectal cancer; Developing countries; Diet; Environment; Gut microbiota; Nuclear receptors

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