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J Nutr. 1993 Feb;123(2 Suppl):418-23.

Colon cancer--do the nutritional epidemiology, the gut physiology and the molecular biology tell the same story?

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  • 1Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454.


Colon carcinogenesis models exist at epidemiologic, physiologic and molecular biologic levels. Thinking about the coherence of such models is useful both to inform colon cancer research and because the reasoning process may be generalizable. The consistent epidemiologic risk factors are low vegetable/fiber and high fat/meat/protein intakes. Others include physical activity, alcohol and reproduction. These epidemiologic risk factors appear to map to physiologic variables that provide mechanistic explanations for the associations: higher bile acids, fiber fermentation and effects of specific anticarcinogens found in vegetables. The possibility that the meat/fat association is due to carcinogens or promoters produced in cooked foods adds complexity to the physiologic model. As a link across genetics, physiology and epidemiology, the role of acetylator status is considered. Finally, whether relationships might exist between the epidemiologic/physiologic risk factors and the recently described molecular genetic changes and other colon cancer molecular mechanisms is considered.

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