ABSTRACT
Colorectal cancer (CRC) is the third most commonly diagnosed cancer in the United States for both men and women. Only lung cancer exceeds it as a cause of cancer-related mortality (1). Through the identification and removal of adenomatous colorectal polyps, opportunities exist not just for early detection, but also for disease prevention. The adenoma-carcinoma sequence remains a paradigm of stepwise human carcinogenesis. The molecular and genetic alterations that characterize this progression, its time course, and phenotypic correlates are increasingly understood. Most CRCs develop in previously benign adenomas. Interruption of this sequence, through screening and mechanical intervention (polypectomy) reduces subsequent CRC incidence (2,3). It is hoped that chemoprevention for persons at average (4,5) and higher risk (6) will also prove beneficial. Unfortunately, neither screening nor chemoprevention is at present widely utilized in the general population (7).
