Hull Rodney, Francies Flavia Zita, Oyomno Meryl, Dlamini Zodwa
SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa.
Department of Surgery, Faculty of Health Sciences, Steve Biko Academic Hospital and the University of Pretoria, Pretoria 0007, South Africa.
Cancer Manag Res. 2020 Oct 9;12:9869-9882. doi: 10.2147/CMAR.S251223. eCollection 2020.
Each year, colorectal cancers (CRCs) affect over a quarter of a million people. The risk of developing CRC in industrialized nations is approximately 5%. When the disease is localised, treatment success rates range from 70-90%; however, advanced CRC has a high mortality rate, consistently ranking in the top three causes of cancer-related deaths. There is a large geographic difference in global distribution, and CRC is predominantly associated with developed countries and a Western lifestyle and diet. As such, the developed world accounts for more than 63% of all cases of CRC. Geographic variations also predict cancer outcomes, which differ between racial and ethnic groups. This variation is due to inequalities in wealth, differences in the exposure to risk factors and barriers to high-quality cancer prevention, early detection and treatment. The aim of this paper was to review CRC in low- and middle-income countries such as South Africa, India, Brazil and China, and compare them with high-income countries such as the United States of America and the United Kingdom. It is important to note that these economically less developed countries, with historically low CRC rates, are experiencing an increased frequency of CRC. The review also discusses biological markers and genetic pathways involved in the development of colorectal cancer. Genes known to be responsible for the most common forms of inherited CRCs have also been identified but more remain to be identified. This would provide more candidate genes to be added to known biomarkers. CRC burden can be controlled through the widespread application of existing knowledge, such as reduced smoking habits, vaccination, early detection and promoting physical activity, accompanied by a healthy diet. An increased understanding of the molecular mechanisms and events underlying colorectal carcinogenesis will enable the development of new targets and therapeutic drugs.
每年，结直肠癌（CRC）影响着超过25万人。在工业化国家，患结直肠癌的风险约为5%。当疾病处于局部阶段时，治疗成功率在70%至90%之间；然而，晚期结直肠癌的死亡率很高，一直位列癌症相关死亡的三大主要原因。全球分布存在很大的地域差异，结直肠癌主要与发达国家以及西方生活方式和饮食相关。因此，发达国家占所有结直肠癌病例的63%以上。地域差异也预示着癌症的预后情况，不同种族和族裔群体之间存在差异。这种差异是由于财富不平等、接触风险因素的差异以及高质量癌症预防、早期检测和治疗的障碍所致。本文的目的是回顾南非、印度、巴西和中国等低收入和中等收入国家的结直肠癌情况，并将其与美国和英国等高收入国家进行比较。需要注意的是，这些经济欠发达国家，历史上结直肠癌发病率较低，但目前结直肠癌发病率正在上升。该综述还讨论了结直肠癌发生过程中涉及的生物标志物和遗传途径。已知导致最常见遗传性结直肠癌形式的基因也已被确定，但仍有更多基因有待发现。这将为已知生物标志物增加更多候选基因。通过广泛应用现有知识，如减少吸烟习惯、接种疫苗、早期检测以及促进体育活动并辅以健康饮食，可以控制结直肠癌负担。对结直肠癌发生的分子机制和事件的深入了解将有助于开发新的靶点和治疗药物。
