{"id":206,"date":"2026-07-27T20:24:19","date_gmt":"2026-07-27T20:24:19","guid":{"rendered":"https:\/\/epinutrition.org\/?page_id=206"},"modified":"2026-08-20T16:31:57","modified_gmt":"2026-08-20T16:31:57","slug":"possible-malignant-progression","status":"publish","type":"page","link":"https:\/\/epinutrition.org\/?page_id=206","title":{"rendered":"Malignant Progression"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">When a Benign Precursor Becomes Invasive Cancer<\/h1>\n\n\n\n<p class=\"wp-block-paragraph\">An adenoma or serrated precursor remains benign while its abnormal cells are confined to the tissue in which the lesion developed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Malignant progression occurs when a population of abnormal cells acquires the ability to invade beyond its normal tissue boundary. Once invasion is present, the lesion is classified as colorectal cancer rather than a benign polyp.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This transition is not inevitable. Most small polyps will never become invasive cancer, and removing recognized precursor lesions is a central purpose of colorectal cancer screening.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;6acc428abb12b&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"6acc428abb12b\" class=\"aligncenter size-large wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"683\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on--pointerdown=\"actions.preloadImage\" data-wp-on--pointerenter=\"actions.preloadImageWithDelay\" data-wp-on--pointerleave=\"actions.cancelPreload\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/08\/malignant-growth-1024x683.png\" alt=\"Invasion is diagnosed when malignant cells cross the normal tissue boundary and grow into supporting tissue where those cells do not belong. This distinction is determined through pathological examination of removed tissue.\n\nProgression from a benign precursor to invasive cancer generally involves the selection and expansion of cell populations carrying additional abnormalities.\" class=\"wp-image-915\" srcset=\"https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/08\/malignant-growth-1024x683.png 1024w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/08\/malignant-growth-300x200.png 300w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/08\/malignant-growth-768x512.png 768w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/08\/malignant-growth.png 1536w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\tdata-wp-bind--aria-label=\"state.thisImage.triggerButtonAriaLabel\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.thisImage.buttonRight\"\n\t\t\tdata-wp-style--top=\"state.thisImage.buttonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\">Additional Changes Are Usually Required<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Invasion is diagnosed when malignant cells cross the normal tissue boundary and grow into supporting tissue where those cells do not belong. This distinction is determined through pathological examination of removed tissue.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Progression from a benign precursor to invasive cancer generally involves the selection and expansion of cell populations carrying additional abnormalities.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These changes may affect:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Growth-promoting and growth-restraining pathways<\/li>\n\n\n\n<li>DNA repair and genomic stability<\/li>\n\n\n\n<li>Cell differentiation and tissue organization<\/li>\n\n\n\n<li>Programmed cell death<\/li>\n\n\n\n<li>Cell adhesion and interaction with surrounding tissue<\/li>\n\n\n\n<li>Immune recognition and inflammatory signaling<\/li>\n\n\n\n<li>Blood-vessel formation<\/li>\n\n\n\n<li>The ability to invade neighboring tissue<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The changes do not necessarily occur in one fixed order. Different colorectal cancers can follow different genetic, epigenetic, and cellular routes to malignancy.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Cancer Development Is an Evolutionary Process<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A polyp may contain multiple related but biologically distinct cell populations. These populations compete within the changing tissue environment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some cell populations disappear. Others persist without becoming invasive. Occasionally, a population with a survival or growth advantage expands and acquires additional capabilities.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This process is often represented as a simple straight line from normal tissue to adenoma to cancer. Human tumor studies show that the underlying biology can be more branched and complex, with multiple evolving cell lineages.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Invasion and Metastasis Are Different Events<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Local invasion is the defining transition from a benign precursor to cancer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Metastasis<\/strong> is a later and separate process in which cancer cells spread to lymph nodes or distant organs. Not every colorectal cancer is metastatic when discovered, and finding cancer at an earlier stage generally permits more treatment options.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Screening is intended to prevent cancer by removing precursors and to detect cancer before symptoms or advanced spread occur.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What the Molecular Evidence Shows<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Human colorectal cancers contain diverse combinations of mutations, chromosomal alterations, DNA-repair abnormalities, and epigenetic changes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Frequently affected pathways include those involving APC and WNT signaling, KRAS, TP53, TGF-\u03b2 signaling, PI3K signaling, and DNA mismatch repair. No single molecular alteration explains every colorectal cancer.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These findings reinforce that malignancy emerges through interacting changes in cell regulation rather than through one metabolic pathway, one food, or one microbial organism.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Summary<\/h2>\n\n\n\n<figure data-wp-context=\"{&quot;imageId&quot;:&quot;6acc428abbaa0&quot;}\" data-wp-interactive=\"core\/image\" data-wp-key=\"6acc428abbaa0\" class=\"wp-block-image size-full is-resized wp-lightbox-container\"><img loading=\"lazy\" decoding=\"async\" width=\"1800\" height=\"1300\" data-wp-class--hide=\"state.isContentHidden\" data-wp-class--show=\"state.isContentVisible\" data-wp-init=\"callbacks.setButtonStyles\" data-wp-on--click=\"actions.showLightbox\" data-wp-on--load=\"callbacks.setButtonStyles\" data-wp-on--pointerdown=\"actions.preloadImage\" data-wp-on--pointerenter=\"actions.preloadImageWithDelay\" data-wp-on--pointerleave=\"actions.cancelPreload\" data-wp-on-window--resize=\"callbacks.setButtonStyles\" src=\"https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/07\/benign-precursor-to-invasive-cancer-copy.png\" alt=\"Diagram showing possible progression from a benign, noninvasive precursor through additional changes and dysplasia to local tissue invasion and possible later progression. Invasion is the decisive boundary at which a lesion is classified as cancer. Before invasion, screening and polyp removal are central; after invasion, diagnosis, staging, and treatment are required. Progression and metastasis are not inevitable.\" class=\"wp-image-207\" style=\"aspect-ratio:1.3838211073102749;width:1178px;height:auto\" srcset=\"https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/07\/benign-precursor-to-invasive-cancer-copy.png 1800w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/07\/benign-precursor-to-invasive-cancer-copy-300x217.png 300w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/07\/benign-precursor-to-invasive-cancer-copy-1024x740.png 1024w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/07\/benign-precursor-to-invasive-cancer-copy-768x555.png 768w, https:\/\/epinutrition.org\/wp-content\/uploads\/2026\/07\/benign-precursor-to-invasive-cancer-copy-1536x1109.png 1536w\" sizes=\"auto, (max-width: 1800px) 100vw, 1800px\" \/><button\n\t\t\tclass=\"lightbox-trigger\"\n\t\t\ttype=\"button\"\n\t\t\taria-haspopup=\"dialog\"\n\t\t\tdata-wp-bind--aria-label=\"state.thisImage.triggerButtonAriaLabel\"\n\t\t\tdata-wp-init=\"callbacks.initTriggerButton\"\n\t\t\tdata-wp-on--click=\"actions.showLightbox\"\n\t\t\tdata-wp-style--right=\"state.thisImage.buttonRight\"\n\t\t\tdata-wp-style--top=\"state.thisImage.buttonTop\"\n\t\t>\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"12\" height=\"12\" fill=\"none\" viewBox=\"0 0 12 12\">\n\t\t\t\t<path fill=\"#fff\" d=\"M2 0a2 2 0 0 0-2 2v2h1.5V2a.5.5 0 0 1 .5-.5h2V0H2Zm2 10.5H2a.5.5 0 0 1-.5-.5V8H0v2a2 2 0 0 0 2 2h2v-1.5ZM8 12v-1.5h2a.5.5 0 0 0 .5-.5V8H12v2a2 2 0 0 1-2 2H8Zm2-12a2 2 0 0 1 2 2v2h-1.5V2a.5.5 0 0 0-.5-.5H8V0h2Z\" \/>\n\t\t\t<\/svg>\n\t\t<\/button><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">References<\/h3>\n\n\n\n<ol start=\"1\" class=\"wp-block-list\">\n<li>Fearon ER, Vogelstein B. A genetic model for colorectal tumorigenesis. <em>Cell.<\/em> 1990;61(5):759\u2013767. doi: <a href=\"https:\/\/doi.org\/10.1016\/0092-8674(90)90186-I\">10.1016\/0092-8674(90)90186-I<\/a>. PMID: 2188735.<\/li>\n\n\n\n<li>Cancer Genome Atlas Network. Comprehensive molecular characterization of human colon and rectal cancer. <em>Nature.<\/em> 2012;487(7407):330\u2013337. doi: <a href=\"https:\/\/doi.org\/10.1038\/nature11252\">10.1038\/nature11252<\/a>. PMID: 22810696; PMCID: PMC3401966.<\/li>\n\n\n\n<li>Tsao JL, Tavar\u00e9 S, Salovaara R, Jass JR, Aaltonen LA, Shibata D. Colorectal adenoma and cancer divergence: evidence of multilineage progression. <em>American Journal of Pathology.<\/em> 1999;154(6):1815\u20131824. doi: <a href=\"https:\/\/doi.org\/10.1016\/S0002-9440(10)65437-5\">10.1016\/S0002-9440(10)65437-5<\/a>. PMID: 10362806; PMCID: PMC2222548.<\/li>\n<\/ol>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-right is-layout-flex wp-container-core-buttons-is-layout-89b4c9e9 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/epinutrition.org\/?page_id=27\" style=\"border-top-left-radius:50px;border-top-right-radius:50px;border-bottom-left-radius:50px;border-bottom-right-radius:50px\">Next: Colon Health Maintenance\u2192<\/a><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>When a Benign Precursor Becomes Invasive Cancer An adenoma or serrated precursor remains benign while its abnormal cells are confined to the tissue in which the lesion developed. Malignant progression occurs when a population of abnormal cells acquires the ability to invade beyond its normal tissue boundary. Once invasion is present, the lesion is classified&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"pmpro_default_level":"","_kad_post_transparent":"","_kad_post_title":"hide","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"class_list":["post-206","page","type-page","status-publish","hentry","pmpro-has-access"],"brizy_media":[],"_links":{"self":[{"href":"https:\/\/epinutrition.org\/index.php?rest_route=\/wp\/v2\/pages\/206","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/epinutrition.org\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/epinutrition.org\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/epinutrition.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/epinutrition.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=206"}],"version-history":[{"count":5,"href":"https:\/\/epinutrition.org\/index.php?rest_route=\/wp\/v2\/pages\/206\/revisions"}],"predecessor-version":[{"id":1246,"href":"https:\/\/epinutrition.org\/index.php?rest_route=\/wp\/v2\/pages\/206\/revisions\/1246"}],"wp:attachment":[{"href":"https:\/\/epinutrition.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=206"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}