Natural selection in neoplastic progression of Barrett's esophagus

Semin Cancer Biol. 2005 Dec;15(6):474-83. doi: 10.1016/j.semcancer.2005.06.004.


Neoplasms progress to cancer through a process of natural selection. The rate of evolution, and thus progression is determined by three parameters: mutation rate, population size of the evolving neoplastic cells, and intensity of selection or rate of clonal expansion. All three parameters are reviewed in the context of Barrett's esophagus, a pre-malignant neoplasm. Although Barrett's esophagus is an ideal model for the study of neoplastic clonal evolution, similar studies may be carried out in a wide variety of human neoplasms. Evolutionary analyses provide insights for clinical management, including rates of progression to cancer and emergence of resistance to interventions.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Barrett Esophagus / genetics*
  • Cell Transformation, Neoplastic / genetics*
  • Disease Progression
  • Esophageal Neoplasms / genetics*
  • Evolution, Molecular*
  • Humans
  • Mutation
  • Selection, Genetic*