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A number of molecular changes are noted in adenomatous polyps and colorectal cancers. The developmental steps toward carcinogenesis include point mutations in the K-ras protooncogene, hypomethylation of DNA. Polyp conversion into cancer depends upon gross appearance of lesion. Polyposis coli is associated with a deletion in the long arm of chromosome 5 in both neoplastic and normal cells.
Hereditary nonpolyposis colon cancer (HNPCC), also known as Lynch’s syndrome, is another autosomal dominant trait. The most effective class of chemo preventive agents is aspirin and other NSAIDS. Screening strategies for colorectal cancer includes digital rectal examination, stool testing, endoscopy. The development of anal cancer is associated with infection by human papillomavirus.