Abstract
A hypothesis has been presented which is compatible with the epidemiological data and which is testable. Initial studies derived from the hypothesis have been described and the results are at least compatible with the hypothesis and to date we have no results that are not explicable on the theory that bacteria, in particular Clostridium paraputrificum. produce carcinogens or cocarcinogens from bile acids. If the hypothesis is true, a major implication is that cancer of the colon is readily preventable by modification of the diet and this has been discussed. If the hypothesis is not true at least we are learning a lot about the metabolic activities of the gut flora, the effect of diet on the flora and on fecal loss of bile acids.