Secondary bile acids: an underrecognized cause of colon cancer

World J Surg Oncol. 2014 May 24;12:164. doi: 10.1186/1477-7819-12-164.


Bile acids were first proposed as carcinogens in 1939. Since then, accumulated evidence has linked exposure of cells of the gastrointestinal tract to repeated high physiologic levels of bile acids as an important risk factor for gastrointestinal cancers. High exposure to bile acids may occur in a number of settings, but most importantly, is prevalent among individuals who have a high dietary fat intake. A rapid effect on cells of high bile acid exposure is the generation of reactive oxygen species and reactive nitrogen species, disruption of the cell membrane and mitochondria, induction of DNA damage, mutation and apoptosis, and development of reduced apoptosis capability upon chronic exposure. Here, we review the substantial evidence of the mechanism of secondary bile acids and their role in colon cancer.

Publication types

  • Review

MeSH terms

  • Bile Acids and Salts / metabolism*
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / physiopathology*
  • Gastrointestinal Neoplasms / etiology*
  • Gastrointestinal Neoplasms / metabolism
  • Humans
  • Prognosis
  • Reactive Nitrogen Species / metabolism*
  • Reactive Oxygen Species / metabolism*


  • Bile Acids and Salts
  • Reactive Nitrogen Species
  • Reactive Oxygen Species