Though it is difficult to explain the reason underlying the stronger association of FGF-21 with risk of non-advanced adenoma than with risk of advanced precancerous lesion, the increment of FGF-21 with progression of colorectal neoplasms from control, non-advanced adenoma to advanced colorectal neoplasia and consistent findings of possible associations with non-advanced adenoma, advanced precancerous lesion and CRC collectively suggest that FGF-21 may be involved in inflammatory and metabolic process at both early and late stages of colorectal tumourigenesis. This evidence concerns the gene FGF21 and colorectal neoplasm.