Development and progression of colorectal cancer based on follow‐up analysis

Abstract

Elucidating the pathway of colorectal cancer development and progression can lead to identification of lesions that must be treated appropriately. The aim of the present review was to summarize the development and progression of colorectal cancer based on radiological and endoscopic follow-up analyses. These studies revealed several characteristic findings, including that initial morphology with progression to advanced cancer was most commonly 0-Is, followed by 0-IIa. Based on the doubling time, 0-Ip grew slowly in comparison with other morphologies. The observation period from adenomas measuring <10 mm to intramucosal cancers was more than 5 years. This makes it difficult to draw any accurate conclusions about the natural history of colorectal cancer based on follow-up observation alone and it is difficult to exclude the selection bias because of the difficulty of follow up for flat and depressed tumor. However, the only reliable way to elucidate the natural history is to accumulate cases.

Aspirin, ibuprofen, and reduced risk of advanced colorectal adenoma incidence and recurrence and colorectal cancer in the PLCO Cancer Screening Trial

“…Notably, these protective effects were observed only after a follow‐up period of 10 years, as further confirmed in a meta‐analysis of 4 RCTs with a mean duration of scheduled aspirin treatment of approximately 6 years and a median follow‐up period of 18 years 11 . This is close to the median follow‐up period of 13 years in our study and may account for the time needed for the completion of the multistep process of tumorigenesis in the natural history of CRC development 52 …”

Personalized Indicator Thrombocytosis Shows Connection to Staging and Indicates Shorter Survival in Colorectal Cancer Patients with or without Type 2 Diabetes

“…Pre-tumor laboratory results have been found for 150 of the 731 patients that were performed at least 30 months prior to the onset of the tumor. Colorectal tumors are expected to develop within several years [72,73], however, since the rate and time of development can be influenced by various factors (such as genetic, environmental, lifestyle etc. ), no exact estimation has been provided previously.…”

Molecular markers for colorectal cancer screening

“…Although there is considerable uncertainty regarding our understanding of the potential for any specific polyp to progress to CRC, some studies have estimated that only 10% of all polyps will progress to CRC and that approximately 25% of advanced polyps will progress to CRC. 22 Until the last 5-10 years, it was believed that only tubular and tubulovillous adenomatous polyps had the potential to progress to CRC; however, it now also appears that 5-30% of all CRCs may evolve from a subset of polyps called sessile serrated polyps and traditional serrated adenomas, which account for roughly 5-10% of all polyps. Sessile serrated polyps and traditional serrated adenomas appear to arise through a series of molecular as well as histological events that are distinct from the adenoma-to-CRC progression sequence.…”