Preventing colorectal cancer.
After decades of little apparent progress against colorectal cancer, we now have the means to avert many of the deaths associated with this malignancy. Earlier diagnosis, either through screening for fecal occult blood or by endoscopy, has been clearly shown to be effective in reducing mortality. There are also prospects for preventing colorectal cancer occurrence through life-style change, since epidemiological studies consistently show that a dietary pattern of high intake of fruits, vegetables, and fiber is associated with a substantially decreased risk of these tumors. A further approach to prevention is the use of pharmacologic agents. Several randomized prevention trials to assess possible preventive drugs or nutrient supplements have focused on patients treated for colorectal adenomas. These trials are feasible, but they pose important challenges in protocol design, recruitment, and patient compliance. Nonsteroidal anti-inflammatory drugs (NSAIDs), especially aspirin, currently appear to be the most promising agents for testing in future trials.
Dartmouth Medical School, Lebanon, NH 03756, USA.
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Greenberg
D000236:Adenoma / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male