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John D. Potter, MD, PhD
University of Minnesota Minneapolis

JAMA. 1993;269(4):474-475.

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In Reply.

—Dr Scott's letter captures nicely the complex nature of the etiology of colon cancer. My article suggested that more than fat and meat on the one hand and complex carbohydrates and fiber on the other are involved in the etiology. For instance, one needs to consider, inter alia, the genetically determined capacity to metabolize arylamines, the hepatic biliary response to fat ingestion, and the degree of anticarcinogenic activity in the colonic mucosa (whether exogenous via vegetables or endogenous via fermentation of fiber). Nonetheless, the net contribution of any of these will vary considerably from one culture to another—some where the increased risk is determined by the amount of carcinogens and promoters in the diet and where the endogenous protection against these compounds is sufficient to inhibit or reduce the likelihood of colon cancer; and others where the endogenous systems need a boost from external anticarcinogens or volatile fatty . . . [Full Text PDF of this Article]

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