The metabolic syndrome and visceral obesity have anincreasing prevalence and incidence in the generalpopulation. The actual prevalence of the metabolicsyndrome is 24% in US population and between24.6% and 30.9% in Europe. As demonstrated by many clinical trials (NAHANES , INTERHART) the metabolic syndrome is associated with an increased risk of both diabetes and cardiovascular disease. In addition to cardiovascular disease, individual components of the metabolic syndrome have been linked to the development of cancer, particularly to colorectal cancer. Colorectal cancer is an important public health problem; in the year 2000 there was an estimated total of 944 717 incident cases of colorectal cancer diagnosed world-wide. This association is sustained by many epidemiological studies. Recent reports suggest that individuals with metabolic syndrome have a higher risk of colon or rectal cancer. Moreover, the clusters of metabolic syndrome components increase the risk of associated cancer. The physiopathological mechanism that links metabolic syndrome and colorectal cancer is mostly related to abdominal obesity and insulin resistance. Population and experimental studies demonstrated that hyperinsulinemia, elevated C-peptide, elevated body mass index, high levels of insulin growth factor-1, low levels of insulin growth factor binding protein-3, high leptin levels and low adiponectin levels are all involved in carcinogenesis. Understanding the pathological mechanism that links metabolic syndrome and its components to carcinogenesis has a major clinical signifi cance and may have profound health benefi ts on a number of diseases including cancer, which represents a major cause of mortality and morbidity in our societies. The metabolic syndrome and visceral obesity have anincreasing prevalence and incidence in the general population. The actual prevalence of the metabolicsyndrome is 24% in US population and between24.6% and 30.9% in Europe. As demonstrated by many clinical trials (NAHANES, INTERHART) the In addition to cardiovascular disease, individual components of the metabolic syndrome have been linked to the development of cancer, particularly to colorectal cancer. in the year 2000 there was an estimated total of 944 717 incident cases of colorectal cancer diagnosed world-wide. Recent reports suggest that individuals with metabolic syndrome have a higher risk of colon or rectal cancer. Moreover , the clusters of metabolic syndrome components increase the risk of associated cancer. T he physiopathological mechanism that links metabolic syndrome and colorectal cancer is mostly related to abdominal obesity and insulin resistance. Population and experimental studies demonstrated that hyperinsulinemia, elevated C-peptide, elevated body mass index, high levels of insulin growth factor-1, low levels of insulin growth factor binding protein-3, high leptin levels and low adiponectin levels are all involved in carcinogenesis. Understanding the pathological mechanism that links metabolic syndrome and its components to carcinogenesis has a major clinical signifi cance and may have profound health benefi ts on a number of diseases including cancer, which represents a major cause of mortality and morbidity in our societies.