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Gastroenterology Research and Practice
Volume 2012 (2012), Article ID 564741, 12 pages
Review Article

How Many Diseases Are Colorectal Cancer?

1Department of Medical Oncology, Christie NHS Foundation Trust, Manchester M20 4BX, UK
2School of Cancer and Imaging Sciences, University of Manchester, Manchester M13 9PL, UK

Received 30 May 2012; Accepted 31 July 2012

Academic Editor: Monique Maas

Copyright © 2012 A. Greystoke and S. A. Mullamitha. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The development of personalised therapy and mechanism-targeted agents in oncology mandates the identification of the patient populations most likely to benefit from therapy. This paper discusses the increasing evidence as to the heterogeneity of the group of diseases called colorectal cancer. Differences in the aetiology and epidemiology of proximal and distal cancers are reflected in different clinical behaviour, histopathology, and molecular characteristics of these tumours. This may impact response both to standard cytotoxic therapies and mechanism-targeted agents. This disease heterogeneity leads to challenges in the design of clinical trials to assess novel therapies in the treatment of “colorectal cancer.”