Colorectal cancer: how does it start? How does it metastasize?

Surg Oncol Clin N Am. 2000 Oct;9(4):643-52; discussion 653-4.


Colorectal carcinogenesis is a multistep process with an apparently orderly progression from benign tissue to invasive malignancy and metastases. Yet at the genome level, a considerably more chaotic situation exists, with order arising through the process of natural selection in the midst of genomic instability. Major pathways for colorectal carcinogenesis begin with suppressor loss or acquisition of a mutator phenotype, but there are other pathways known and yet to be described. These pathways result in the natural selection of cells with unstable genomes leading to malignancy and metastases.

Publication types

  • Review

MeSH terms

  • Animals
  • Carcinoma / genetics*
  • Carcinoma / pathology
  • Carcinoma / secondary*
  • Cell Transformation, Neoplastic / pathology*
  • Colorectal Neoplasms / genetics*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / physiopathology
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Male
  • Neoplasm Invasiveness / physiopathology*
  • Prognosis
  • Risk Assessment