ArticleGut2012
Assessment of colorectal cancer molecular features along bowel subsites challenges the conception of distinct dichotomy of proximal versus distal colorectum.
Article in Gut, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 391 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
391 citing papers in PubMed, 9 syntheses or guidelines pooled it, 598 citations in OpenAlex.
- Controversies in the treatment of RAS wild-type metastatic colorectal cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2021Guideline
- Site-specific risk of colorectal neoplasms in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Tumor-associated macrophage infiltration and prognosis in colorectal cancer: systematic review and meta-analysis.International journal of colorectal disease · 2020Pooled it
- Pooled it
- Meta-analysis of 16 studies of the association of alcohol with colorectal cancer.International journal of cancer · 2020Pooled it
- Survival Rate of Colorectal Cancer in Iran: A Systematic Review and Meta-AnalysisAsian Pacific journal of cancer prevention : APJCP · 2019Pooled it
- Pooled it
- Continuity of transcriptomes among colorectal cancer subtypes based on meta-analysis.Genome biology · 2018Pooled it
- Meta-analysis of the prognostic value of CpG island methylator phenotype in rectal cancer.International journal of colorectal disease · 2018Pooled it
- Evaluating the utility ofEpigenetics · 2024Trial
- Trial
- A Modified Tumor-Node-Metastasis Classification for Primary Operable Colorectal Cancer.JNCI cancer spectrum · 2021Trial
- Prognostic variables in low and high risk stage III colon cancers treated in two adjuvant chemotherapy trials.European journal of cancer (Oxford, England : 1990) · 2021Trial
- Tumour location and efficacy of first-line EGFR inhibitors inESMO open · 2019Trial
- Trial
- Colorectal cancer landscape from gut microbiota: Insights into mutations, epigenetic dysregulation, and immune microenvironment alterations.Virulence · 2026Review
- Tumor Vascular Features and Colorectal Cancer-Specific Mortality.JAMA network open · 2026Article
- Integrated Spatial and Bulk Untargeted Metabolomics Characterize Location- and Histology-Associated Metabolic Heterogeneity in Colorectal Cancer.Journal of proteome research · 2026Article
- Evaluating statistical models for overdispersed multiomics data: a multiplex immunofluorescence case study.American journal of epidemiology · 2026Article
- Cigarette smoking and long-term incidence of colorectal cancer subclassified by tumor-infiltrating myeloid cells: A prospective cohort study.Environmental pollution (Barking, Essex : 1987) · 2026Article
331 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveColorectal cancer is typically classified into proximal colon, distal colon and rectal cancer. Tumour genetic and epigenetic features differ by tumour location. Considering a possible role of bowel contents (including microbiome) in carcinogenesis, this study hypothesised that tumour molecular features might gradually change along bowel subsites, rather than change abruptly at splenic flexure.
designUtilising 1443 colorectal cancers in two US nationwide prospective cohort studies, the frequencies of molecular features (CpG island methylator phenotype (CIMP), microsatellite instability (MSI), LINE-1 methylation and BRAF, KRAS and PIK3CA mutations) were examined along bowel subsites (rectum, rectosigmoid junction, sigmoid, descending colon, splenic flexure, transverse colon, hepatic flexure, ascending colon and caecum). The linearity and non-linearity of molecular relations along subsites were statistically tested by multivariate logistic or linear regression analysis.
resultsThe frequencies of CIMP-high, MSI-high and BRAF mutations gradually increased from the rectum (<2.3%) to ascending colon (36-40%), followed by falls in the caecum (12-22%). By linearity tests, these molecular relations were significantly linear from rectum to ascending colon (p<0.0001), and there was little evidence of non-linearity (p>0.09). Caecal cancers exhibited the highest frequency of KRAS mutations (52% vs 27-35% in other sites; p<0.0001).
conclusionsThe frequencies of CIMP-high, MSI-high and BRAF mutations in cancer increased gradually along colorectum subsites from the rectum to ascending colon. These novel data challenge the common conception of discrete molecular features of proximal versus distal colorectal cancers, and have a substantial impact on clinical, translational and epidemiology research, which has typically been performed with the dichotomous classification of proximal versus distal tumours.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.