Epidemiology of colonic aberrant crypt foci: Review and analysis of existing studies

Abstract

Since first described in a rodent model in 1987, aberrant crypt foci (ACF) in the colon have been shown to exhibit many of the molecular features of the more advanced colonic neoplasms including cancer. Therefore, they may be early lesions with potential for progression, and be valuable biomarkers for reduction of risk of colorectal cancer (CRC). For this review, we searched PubMed, and reference lists of recent publications, for studies which reported on associations of features of ACF in humans, such as number or size, with subject characteristics, such as age or family history of CRC. Over 150 papers have reported on ACF in humans. However, the vast majority of these publications are concerned with molecular and morphological features of biopsied lesions, and not their epidemiology. None of the epidemiological studies were of optimum design, primarily due to their absence of a well-defined subject sampling frame or method. Given their 'first-generation' nature, consistent findings were of increased ACF number with age and with synchronous advanced colonic neoplasia. One study reported a higher mean number of ACF in subjects with a family history of CRC than in those without. The strongest evidence on the ability of ACF to predict a diagnosis of CRC will be from prospective studies with baseline ACF assessment in a large sample of diseasefree persons (many thousands) who are followed carefully for many years. In the interim, because ACF are asymptomatic, well-designed cross-sectional studies are feasible and will yield valuable information on the relation of ACF to the known risk factors for CRC. This information can then be used to improve the design of prospective studies, and of clinical intervention trials that use ACF as an intermediate endpoint.

Prevention of DNA damage and anticarcinogenic activity of Activia^® in a preclinical model

“…Alcohol intake, cigarettes, and diet habits (low intake of natural products and excess quantity of processed meat) may also increase the risk of colorectal cancer (Stevens et al, 2007).…”

Resistant starch: a functional food that prevents DNA damage and chemical carcinogenesis

“…Thus, diet, functional foods, or both, that alter gene expression might correlate with the prevention of such neoplasms (Bergmann et al, 2006). Conversely, according to Chao et al (2005) and the World Cancer Research Fund (1997), diets that contain high concentrations of protein, including red or processed meats, animal fats, alcohol, and carbohydrates (Stevens et al, 2007), are associated with a high risk of these tumors.…”

Evaluation of the antimutagenic and anticarcinogenic effects of inulin in vivo

“…Among the variety of factors that are implicated in the etiology of colorectal tumors are genetic factors as well as environmental factors such as a diet rich in fat and meat and poor in fruits, vegetables, and cereals (Stevens et al, 2007).…”