Progressing toward a molecular description of colorectal cancer development.

During the past decade, the powerful techniques of molecular biology and genetics have been applied to the study of human cancer. Colorectal tumors have proved to be an excellent system in which to search for and study the mutations involved in the development and progression of a common human cancer because of their natural history and several inherited syndromes that strongly predispose to colorectal cancer. A current view is that colorectal cancer results, at least in part, from the accumulation of multiple mutations in oncogenes and tumor suppressor genes in an affected cell. Although the genetic alterations often occur in a preferred sequence, the total accumulation of changes, rather than their order with respect to one another, appears to be a critical determinant of the biological properties of the tumor cell. Study of the inherited and somatic mutations in colorectal tumor cells may provide insights not only into the pathogenesis of cancer, but may also lead to future understanding of the mechanisms of the origin of mutations and the role of environmental and dietary factors in colorectal tumor development.