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Eur J Cancer. 1995 Jul-Aug;31A(7-8):1033-8.

Risk factors for colon neoplasia--epidemiology and biology.

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  • 1Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington State 98104, USA.


Epidemiological, physiological and molecular models of colon carcinogenesis have been proposed. Consistent epidemiological risk factors include reduced plant-food intake (increased risk); elevated meat intake (increased risk); higher physical activity (reduced risk); and increased alcohol intake (increased risk). At the physiological level, these lifestyle variables may trigger processes that provide explanations for the associations: higher meat, fat and alcohol means more heterocyclic amines and higher levels of bile acids; higher plant food means higher intake of several anticarcinogens and fibre fermentation that produces volatile fatty acids; exercise has a variety of beneficial effects. This complexity is elaborated further in the context of the colonic milieu where interactions among digesta, bacteria and epithelial cells occur. The long-term likelihood of cancer is the summation of moment-to-moment changes in the colonic milieu brought about by this interaction. Possible relationships between established epidemiological risk factors, genetic susceptibility and somatic genetic changes are outlined.

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