title: Chemoprevention of gastrointestinal malignancies.
abstract: BACKGROUND
  There has been considerable interest in the use of chemical or dietary agents to suppress or inhibit the development of tumours in the early stages of carcinogenesis. This concept is known as chemoprevention and although the potential for such agents is tremendous, evaluating their clinical benefit is beset with difficulties.
  
  
  OBJECTIVE
  Using selected agents, such as curcumin and indole-3-carbinol, as examples, the present review will discuss the possible mechanisms of chemoprevention and the problems encountered in developing these agents into clinical drugs.
  
  
  METHODS
  A review of the published literature from 1985 to the present day was performed using Medline and Web of Science search engines. Key words used were 'gastrointestinal cancer' and 'chemoprevention'.
  
  
  CONCLUSIONS
  A huge number of agents with possible chemopreventive action has been identified. Pilot trials using molecular signatures of cancer activity can be used to select which agents should be included in large-scale phase III clinical trials. Publications concerning chemoprevention are concentrated in the scientific and oncological literature but surgeons with their greater exposure to premalignant gastrointestinal disease need to be aware of current concepts in this rapidly expanding field. This knowledge would allow collaboration between oncologists and surgeons in clinical trials to further evaluate chemopreventive compounds and ascertain their clinical impact.
authors.affiliation: University Department of Oncology, The Leicester Royal Infirmary, Leicester, United Kingdom. gg43@le.ac.uk
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Garcea
authors.forename: Ashley R
authors.initials: AR
authors.lastname: Dennison
authors.forename: Will P
authors.initials: WP
authors.lastname: Steward
authors.forename: David P
authors.initials: DP
authors.lastname: Berry
mesh_terms: D016588:Anticarcinogenic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001682:Biological Availability; D004260:DNA Repair / Q000187:drug effects; D004791:Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D005770:Gastrointestinal Neoplasms / Q000517:prevention & control*; D006801:Humans
chemical_list: D016588:Anticarcinogenic Agents; D004791:Enzyme Inhibitors