Cause, Epidemiology, and Histology of Polyps and Pathways to Colorectal Cancer

Gastrointest Endosc Clin N Am. 2022 Apr;32(2):177-194. doi: 10.1016/j.giec.2021.12.001. Epub 2022 Feb 22.

Abstract

Colorectal cancer is the second leading cause of cancer-associated mortality, with a lifetime risk of approximately 4% to 5%. Colorectal cancer develops from the sequential acquisition of defined genetic mutations in the colonic epithelium. Tumorigenesis from normal tissue to cancer occurs largely through 3 pathways: the chromosomal instability pathway, the microsatellite instability pathway, and the sessile serrated pathway. Colorectal cancer incidence and mortality have decreased by approximately 35% since the beginning of screening programs in the 1990s, although other factors such as use of aspirin for coronary disease prevention and decreased smoking rates may also be important. In this review, we discuss the etiology, epidemiology, and histology of colorectal polyps and cancer.

Keywords: Adenoma; Colon cancer screening; Colon polyp; Colorectal cancer.

Publication types

  • Review

MeSH terms

  • Adenoma* / pathology
  • Cell Transformation, Neoplastic
  • Colonic Polyps* / epidemiology
  • Colonic Polyps* / genetics
  • Colorectal Neoplasms* / etiology
  • Colorectal Neoplasms* / genetics
  • Humans