Role of anabolic agents in colorectal carcinogenesis: Myths and realities (Review)

Krasanakis,Theodore; Nikolouzakis,Taxiarchis   Konstantinos; Sgantzos,Markos; Mariolis‑Sapsakos,Theodore; Souglakos,John; Spandidos,Demetrios  A.; Tsitsimpikou,Christina; Tsatsakis,Aristidis; Tsiaoussis,John

doi:10.3892/or.2019.7351

Role of anabolic agents in colorectal carcinogenesis: Myths and realities (Review)

Authors:
- Theodore Krasanakis
- Taxiarchis Konstantinos Nikolouzakis
- Markos Sgantzos
- Theodore Mariolis‑Sapsakos
- John Souglakos
- Demetrios A. Spandidos
- Christina Tsitsimpikou
- Aristidis Tsatsakis
- John Tsiaoussis
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Affiliations: Laboratory of Anatomy‑Histology‑Embryology, Medical School, University of Crete, 71110 Heraklion, Greece, Faculty of Medicine, Department of Anatomy, Faculty of Medicine, University of Thessaly, 41221 Larissa, Greece, National and Kapodistrian University of Athens, Agioi Anargyroi General and Oncologic Hospital of Kifisia, 14564 Athens, Greece, Department of Medical Oncology, University General Hospital of Heraklion, 71110 Heraklion, Greece, Laboratory of Clinical Virology, Medical School, University of Crete, 71409 Heraklion, Greece, General Chemical State Laboratory of Greece, 11521 Athens, Greece, Department of Forensic Sciences and Toxicology, Medical School, University of Crete, 71409 Heraklion, Greece
Published online on: October 3, 2019 https://doi.org/10.3892/or.2019.7351
Pages: 2228-2244
Copyright: © Krasanakis et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Colorectal cancer (CRC) is one of the four leading causes of cancer‑related mortality worldwide. Even though over the past few decades the global scientific community has made tremendous efforts to understand this entity, many questions remain to be raised on this issue and even more to be answered. Epidemiological findings have unveiled numerous environmental and genetic risk factors, each one contributing to a certain degree to the final account of new CRC cases. Moreover, different trends have been revealed regarding the age of onset of CRC between the two sexes. That, in addition to newly introduced therapeutic approaches for various diseases based on androgens, anti‑androgens and anabolic hormones has raised some concerns regarding their possible carcinogenic effects or their synergistic potential with other substances/risk factors, predisposing the individual to CRC. Notably, despite the intense research on experimental settings and population studies, the conclusions regarding the majority of anabolic substances are ambiguous. Some of these indicate the carcinogenic properties of testosterone, dihydrotestosterone (DHT), growth hormone and insulin‑like growth factor (IGF) and others, demonstrating their neutral nature or even their protective one, as in the case of vitamin D. Thus, the synergistic nature of anabolic substances with other CRC risk factors (such as type 2 diabetes mellitus, metabolic syndrome and smoking) has emerged, suggesting a more holistic approach.

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