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Review
. 2006;51(5):391-396.
doi: 10.1007/s10038-006-0373-x. Epub 2006 Apr 5.

Cancer genetics: colorectal cancer as a model

Walter F Bodmer  1
Affiliations
Review

Cancer genetics: colorectal cancer as a model

Walter F Bodmer. J Hum Genet. 2006.

Abstract

Cancer is essentially a somatic evolutionary process and is, therefore, effectively defined by the genetic and epigenetic changes underlying this process. An understanding of the function of these changes is fundamental to devising new approaches to prevention and treatment. Colorectal cancer (CRC), apart from its obvious importance as one of the most frequent cancers, provides an excellent model for such studies because of the availability of precursor adenoma lesions and the existence of several clear-cut familial inherited susceptibilities. These include familial adenomatous polyposis (FAP), which led to the identification of the APC gene and the importance of the Wnt pathway, and hereditary non-polyposis CRC (HNPCC), which identified the role of the mismatch repair genes in colorectal and other cancers. The presently known range of genetic and epigenetic changes in CRCs and adenomas is reviewed in this paper and the evidence against a requirement for genomic instability presented, together with a discussion of patterns of gene methylation, including especially our work on the homeobox gene, CDX1. Clearly, familial cancers, such as FAP and HNPCC, cannot account for more than perhaps 5% of the incidence of CRC. There is, however, evidence that approximately a further 25-30% have some inherited susceptibility. Based on the association of APC missense variants with multiple adenomas, we proposed that much of this may be due to the cumulative effects of low frequency, low penetrance variants, and the "rare variant hypothesis". The evidence for this from our work on multiple adenoma cases, and certain other examples, is discussed.

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Figures

Fig. 1
Fig. 1
Adenoma to carcinoma sequence
Fig 2
Fig 2
CDX1 promoter methylation and mRNA expression for three colorectal cancer cell lines. Each small circle represents the position of a CpG site in the promoter region. Filled circles indicate methylated Cs. The results from ten clones are shown for each cell line
Fig 3
Fig 3
Scheme for inherited susceptibility to colorectal cancer
See this image and copyright information in PMC

References

    1. Bodmer WF. Familial adenomatous polyposis (FAP) and its gene, APC. Cytogenet Cell Genet. 1999;86:99–104. - PubMed
    1. Fearnhead NS, et al. The ABC of APC. Hum Mol Genet. 2001;10(7):721–733. - PubMed
    1. Fearnhead NS, Wilding JL, Bodmer WF. Genetics of colorectal cancer: hereditary aspects and overview of colorectal tumorigenesis. Br Med Bull. 2002;64:27–43. - PubMed
    1. Fearnhead NS, Wilding JL, Winney B, Tonks S, Bartlett S, Bicknell DC, Tomlinson IPM, Mortensen NJ, Bodmer WF. Multiple rare variants in different genes account for multifactorial inherited susceptibility to colorectal adenomas. Proc Natl Acad Sci USA. 2004;101:15992–15997. - PMC - PubMed
    1. Fearnhead NS, Winney B, Bodmer WF. Rare variant hypothesis for multifactorial inheritance: susceptibility to colorectal adenomas as a model. Cell Cycle. 2005;4:521–525. - PubMed