Published online Nov 15, 2015. doi: 10.4291/wjgp.v6.i4.86
Peer-review started: June 4, 2015
First decision: July 6, 2015
Revised: September 2, 2015
Accepted: September 16, 2015
Article in press: September 18, 2015
Published online: November 15, 2015
Processing time: 167 Days and 20.3 Hours
Colorectal cancer (CRC) that comprises about 50% of estimated gastrointestinal cancers remains a high mortality malignancy. It is estimated that CRC will result in 9% of all cancer related deaths. CRC is the third leading malignancy affecting both males and females equally; with 9% of the estimated new cancer cases and 9% cancer related deaths. Sporadic CRC, whose incidence increases markedly with advancing age, occurs in 80%-85% patients diagnosed with CRC. Little is known about the precise biochemical mechanisms responsible for the rise in CRC with aging. However, many probable reasons for this increase have been suggested; among others they include altered carcinogen metabolism and the cumulative effects of long-term exposure to cancer-causing agents. Herein, we propose a role for self-renewing, cancer stem cells (CSCs) in regulating these cellular events. In this editorial, we have briefly described the recent work on the evolution of CSCs in gastro-intestinal track especially in the colon, and how they are involved in the age-related rise in CRC. Focus of this editorial is to provide a description of (1) CSC; (2) epigenetic and genetic mechanisms giving rise to CSCs; (3) markers of CSC; (4) characteristics; and (5) age-related increase in CSC in the colonic crypt.
Core tip: Sporadic colorectal cancer (CRC), an age-related disease, occurs in 80%-85% of patients with CRC. The changes that occur at the cellular and molecular levels during ageing leading to a rise in CRC are poorly understood. We have postulated a role for cancer stem/stem-like cells that are shown to possess self-renewing, pluripotent properties. These cells, which reside at the bottom of the colonic crypt, are thought to regulate the processes of carcinogenesis. In this editorial, we have briefly described the recent work on the evolution of cancer stem cells in gastro-intestinal tract with particular reference to the colon, and how they are involved in the development and progression of CRC, the incidence of which increases with advancing age.