The pathology of colon and rectal neoplasia provides key information for the multidisciplinary management of patients with these diseases.  In those patients who have developed colon or rectal carcinoma (CRC), pathologic diagnosis and characterization are the starting point for decision about treatment, and the stage of the disease that portends prognosis informs the options that are considered by the gastroenterologist, surgeon, medical oncologist and radiation oncologist. In addition, pathology provides information about the setting of the carcinoma that has implications for the approach to the patient (e.g. CRC in the setting of a chronic inflammatory bowel disease such as ulcerative colitis or Crohn disease), but also to the patient’s family members (e.g. CRC in a hereditary syndrome).  The pathologic types of precursor lesions for CRC influence strategies for risk assessment, screening, and surveillance.

The subspecialty of molecular pathology is fulfilling ever increasing roles in multidisciplinary care as the pathogenesis of the molecular alterations, and especially their implications for tumor biology, are understood and applied clinically.

Molecular pathways in colorectal neoplasia:

Clinical uses of biomarkers: