Summary People at risk from coronary heart disease and large bowel cancer are drawn from the same urbanised, industrialised Western populations. Whilst changes in blood lipids are well recognised in heart disease, little is known of their role in large bowel cancer. This study investigates serial alterations in blood lipids in the 1,2-dimethylhydrazine (DMH) rat model of colon cancer. Eighty Wistar rats received a 5 weekly regimen of DMH. At week 10, and at 5 weekly intervals until week 40, random groups of 10 rats were killed and blood taken for total and free cholesterol, phospholipids, triglycerides and liver enzymes. All colonic neoplasms were histologically classified either as adenomas or carcinomas with groups being allocated into tumour-free (n = 16) or tumour-bearing (n = 54), the latter group being further sub-divided into animals with adenoma alone (n =8) and those with carcinoma (n = 46). Results were considered both sequentially and according to tumour status. Sequential results showed that with increase in colonic neoplasms with time there were accompanying increases in free and % free cholesterol and in phospholipids (P<0.001). There were no changes in total cholesterol, triglycerides or liver enzymes. Results according to tumour status showed that whilst there was no difference in total cholesterol or triglycerides between tumour-free and tumour-bearing rats, there was a significant increase in free (P<0.01) and % free cholesterol (P<0.001) and a decrease in phospholipids in the tumour-bearing animals (P<0.001). There was no difference in any serum lipid between tumour-free and adenoma-bearing rats. In animals with carcinoma, while there was no difference in total cholesterol or triglycerides, there was an increase in free (P<0.005) and % free cholesterol (P<0.001) and a decrease in phospholipids (P<0.001) compared to tumour-free rats.The data show for the first time a clear relationship between blood lipids and the presence or absence of large bowel cancer.The incidence and mortality rates for large bowel cancer are the second highest of all malignant disease in Western society (American Cancer Society, 1978). Although the cause(s) of colon cancer is unknown, epidemiological studies have implicated dietary fats in the pathogenesis of this disease (Wynder, 1975;Doll, 1978;Wynder & Reddy, 1983). More specifically, cholesterol in the diet has been shown to be co-carcinogenic in animals (Cruse et al., 1978(Cruse et al., ,1982 and there is indirect evidence for a similar role in man (Cruse et al., 1979;Broitman, 1981).Populations at high risk for colorectal cancer (CRC) are similarly at high risk of coronary heart disease (CHD) (Hill, 1975;Wynder & Shigematsu, 1967) and a common factor for both diseases is the high fat intake of the 'at risk' population (Hill, 1975). The familiar direct relationship between serum cholesterol levels and CHD probably reflects a causal role between hypercholesterolaemia and atherosclerosis (Lewis, 1983). Recent evidence also indicates that a direct but inverse relation...