Факторы риска и канцерогенез колоректального рака

Цель: представить данные о факторах риска и их участии в канцерогенезе колоректального рака.

Основные положения. Колоректальный рак (КРР) занимает третье место в структуре заболеваемости злокачественными опухолями в большинстве стран мира, включая Россию. При этом заболеваемость продолжает расти и в мире, и в России, где КРР составляет 12,2 % в общей онкологической заболеваемости. Остановить рост и добиться существенного снижения заболеваемости КРР возможно только на основе определения доказанных причин и факторов риска КРР и внедрения в систему здравоохранения эффективных мер его профилактики. Обзор включает три раздела исследований: распространение КРР в популяциях и динамика показателей заболеваемости; причины и модифицируемые и немодифицируемые факторы риска КРР; механизмы канцерогенеза КРР. Большинство случаев КРР (90–95 %) носит спорадический характер и в значительной степени обусловлено совокупностью модифицируемых факторов риска окружающей среды и образа жизни, таких как определенные характеристики питания, микробиота кишечника, вес, физическая активность, употребление алкоголя, табакокурение, предопухолевые заболевания ободочной и прямой кишки, уровень знаний о причинах злокачественных новообразований и мерах их профилактики. Предполагается, что около 30 % случаев заболеваний КРР в разной степени обусловлено наследственной предрасположенностью или немодифицируемыми факторами риска, но лишь 5 % всех случаев КРР развиваются на фоне известных наследственных синдромов, которые вызваны определенной герминальной мутацией.

Заключение. Представленные в обзоре данные о доказанных модифицируемых и немодифицируемых факторах риска КРР и механизмах их участия в канцерогенезе злокачественных новообразований толстой или прямой кишки будут способствовать разработке и внедрению в практическое здравоохранение эффективных методов профилактики и снижению заболеваемости КРР.

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