W. Scheppach – författare

This text presents the proceedings of Falk Symposium 128, held in Wurzburg, Germany, on May 2-3, 2002, and dedicated to the important issue of colonic carcinogenesis and its underlying genetic and environmental factors. Colorectal cancer is one of the leading causes of cancer-related death in industrialized countries. It has been recognized to be the consequence of a dynamic process leading from hyperproliferative epithelium through different classes of adenomas to invasive carcinoma. This adenoma-carcinoma sequence has been characterized on a molecular basis. Modern molecular biology has also helped to clarify the clustering of colorectal cancer within families, a phenomenon that has been known to clinicians for a long time. Thus, the pathogenesis of the two distinct familial colon cancer syndromes FAP (familial adenomatous polyposis) and HNPCC (hereditary non-polyposis colorectal cancer) is increasingly being understood. Thereby, an identification of affected people has become possible before the disease has manifested. There is also convincing evidence that the pathogenesis of sporadic colonic cancer is modulated by environmental, mainly nutritional, factors.Carcinogens seem to be far less important than the components of the "normal" human diet. It is likely that the interplay between protective and noxious dietary compounds determines the progression of the adenoma-carcinoma sequence. Additionally, a broad spectrum of drugs has been shown to affect colonic tumorigenesis, which provides the rationale for chemoprevention strategies. These issues set the scene for discussions on how genetic and environmental factors may interact in the pathogenesis of colonic cancer, contributing fresh ideas to the prevention of this most prevalent malignancy in the industrialized world.

This book covers all aspects of gastrointestinal and liver malignancies (epidemiology, pathophysiology, screening where appropriate, symptoms and clinical signs, diagnostic studies, staging and classification, treatment, prognosis, follow-up, future perspectives). It is addressed to those involved in the multidisciplinary approach to the gastrointestinal cancer patient (gastroenterologists, medical oncologists, radiation therapists, surgeons, interventional radiologists, pathologists, nurses, and physicians-in-training). The book provides in-depth information, illustrated by numerous color/black-and-white pictures. Selective reading for a quick reference is made possible by introducing text elements such as summaries, tables, listing and treatment algorithms.

Cancer of the digestive system, which includes the gastrointestinal tract, liver, pancreas and gall bladder, represents a major cause of cancer mor­ bidity and mortality worldwide. In the year 2000, these malignancies were responsible for 30% of all cancers and 36% of all cancer-associated deaths (Parkin DM, Bray Fl, Devesa SS, Cancer burden in the year 2000. The global picture. Eur J Cancer 2001; 37: S4-66). This book provides a concise, but more than adequate overview of these malignancies and their premalignant states. It gives updated in­ formation on etiology - whether genetic or environmental, pathology, clinical features and treatments. It also gives information on screening, prevention and chemoprevention, where available. Understanding these latter features are of prime importance as we clinicians are moving from treatment of endstage disease, to prevention, chemoprevention and early diagnosis in order to reduce the cancer burden, to try and delay or at least modulate its manifestations and cure it by diagnosing in the earli­ est and curable stage.