Figure 1: Inflammation plays multiple roles in the development of colorectal neoplasms. 1. The inflammatory response is directed toward an auto-amplifying Th17 response, which contributes to DNA damage in epithelial cells by production of reactive oxygen species (ROS). 2. DNA damage leads to dysfunction in epithelial cell junctional proteins creating a “leaky gut” which permits close association between inflammation-inducing microorganisms and epithelial cells. 3. Inflammation leads to selection and expansion of specific members of the microbial community, some of which have genotoxic capabilities that contribute to DNA damage in epithelial cells.