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Biomedicines
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5 November 2025

Role of Bisphenol A in the Development and Progression of Colorectal Cancer: Possible Sex-Specific Effects of Endogenous and Exogenous Estrogens

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1
Center for Gender-Specific Medicine, Italian National Institute of Health, 00161 Rome, Italy
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Core Facilities Service, Italian National Institute of Health, 00161 Rome, Italy
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Istituto Zooprofilattico Sperimentale del Lazio e della Toscana, Via Appia Nuova 1411, 00178 Rome, Italy
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Center for Advanced Studies and Technology (CAST), Università degli Studi “G. d’Annunzio” Chieti–Pescara, via Luigi Polacchi 11, 66100 Chieti, Italy
Biomedicines2025, 13(11), 2717;https://doi.org/10.3390/biomedicines13112717 
(registering DOI)
This article belongs to the Special Issue Gastrointestinal Diseases: From Pathophysiology to Innovative Therapeutic Approaches

Abstract

Background: Colorectal cancer (CRC) is more prevalent in men, and premenopausal women have a better prognosis than both men and postmenopausal women, suggesting a protective effect of estrogen. Humans are exposed to estrogen-like contaminants such as bisphenol A (BPA), a chemical used in the production of plastics that has been linked to hormone-related malignancies (e.g., breast, ovarian, and prostate cancers). The natural flavonolignan compound silibinin (SIL), acting as an estrogen agonist, may play a protective role in CRC in one or both sexes. Objectives: To explore the possible association between BPA and CRC, focusing on its potential pro-tumor role and possible gender differences. Analyzing the possible protective effects of SIL on the development of CRC is the secondary objective of the project. Methods: To shed light on the interaction between sex and estrogens, both endogenous and exogenous, in the onset of CRC. To this end, we combined ex vivo, in vitro, and in vivo approaches to deepen our understanding of the molecular mechanisms involved. Conclusions: The data provided by this study will contribute to understanding the role of estrogens and their receptors in the onset and progression of CRC and the potential protective role of SIL in both sexes.

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