Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.6055
Revised: February 20, 2014
Accepted: April 15, 2014
Published online: May 28, 2014
Colorectal cancer (CRC) is one of the leading causes of cancer and cancer-related mortality worldwide. The disease has been traditionally a major health problem in industrial countries, however the CRC rates are increasing in the developing countries that are undergoing economic growth. Several environmental risk factors, mainly changes in diet and life style, have been suggested to underlie the rise of CRC in these populations. Diet and lifestyle impinge on nuclear receptors, on the intestinal microbiota and on crucial molecular pathways that are implicated in intestinal carcinogenesis. In this respect, the epidemiological transition in several regions of the world offers a unique opportunity to better understand CRC carcinogenesis by studying the disease phenotypes and their environmental and molecular associations in different populations. The data from these studies may have important implications for the global prevention and treatment of CRC.
Core tip: This highlight addresses the rise of colorectal cancer (CRC) in the developing countries. We review the epidemiological data on the growing CRC burden in these countries, discuss the role of changing environmental risk factors, and examine preventive strategies that could contribute to control the spread of CRC. The molecular pathways of CRC and the roles of nuclear receptors and of the intestinal microbiota are discussed in the light of the current epidemiological transition.