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By Bernard Levin, Paul Rozen, Stephen J. Spann, Graeme P. Young

The swift price of improvement within the fields of prevention, early detection and administration for colorectal melanoma implies that the profitable first version of this obtainable consultant has had to be up to date and revised all through. fundamental care physicians and experts alike will proceed to discover this an quintessential synopsis of the problems and ideas.

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Extra resources for Colorectal Cancer in Clinical Practice: Prevention, Early Detection and Management, Second Edition

Example text

Small colorectal carcinomas. normally arise in dotal clrnical, and therapeutic data. 5 Time course of sporadic colorectal cancer development in the human colon. Subsequent figures show the alternative pathways for the dominantly inherited cancer syndromes. Progression of oncogenesis may be characterized by (all or some number of polyps. o~J increasing polyp size, amount of villous histology, degree of dysplasia, and increasing 33 COLORECTAL CANCER IN CLINICAL PRACTICE with adenomas are relatively rare in Western countries.

Increases with histologic progression; early methylation of SLCSAB; and additional methylation of several other genes, including p16 and MGMP9 lifestyle itself (see Chapters 1, 2 and 4). As is apparent from the discussion above on the process of oncogenesis and the mechanisms of genomic change that lead to cancers, many of these genomic events must be acquired. Other pathways At present, the possibility of even another molecular path- in DNA; they also, and perhaps at least as importantly, way for the 'de novo' cancers, observed especially in regulate the biologic consequences of altered DNA.

To an accumulation of oncogene mutations or suppressor gene deletions. ;: more muci- CIN Pathway nous tumors at a more proximal location and a more The CIN pathway is the most common and reflects the promi nent lymphoid react ion. ncers, especially sporadic (sometimes and serves to facilitate diagnosis (see Chapter 6). called 'common') colorectal cancer. A range of observations suggest th

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