The molecular basis for prevention of colorectal cancer.

Colorectal cancer is the second leading cause of cancer death in the United States. Despite aggressive treatment and early screening strategies, the prognosis for patients with advanced disease remains poor. Extensive research examining familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC), two common forms of inherited colorectal cancer, have provided invaluable insights into some of the molecular mechanisms underlying both familial, as well as nonfamilial, colorectal cancer. The molecules involved in these pathways may provide effective targets for prevention and/or treatment of colorectal cancer. These targets include cyclooxygenase-2 (COX-2), peroxisome proliferator-activated receptor (PPAR)-delta, PPAR-gamma, transforming growth factor-beta receptor type II, epidermal growth factor receptor, and inducible-nitrous oxide synthase.