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Figure The different stages of colorectal cancer are well characterised clinically – from an abnormal epithelium to metastasis. Mutations in certain genes, implicated in the process of carcinogenesis, are typically found at different stages. Thus, for instance, mutations leading to activation of K-ras protooncogene are found in about half of all adenomas, while loss of p53 (tumour suppressor) function is generally found later in the sequence.

An inherited mutation in the APC [adenomatous polyposis coli] gene is responsible for the disease familial adenomatous polyposis. Mutations in APC are also found in sporadic colorectal cancer.