Review article: chemoprevention of colorectal cancer.
Colorectal cancer is a disease with a high mortality at present, due to the late stage at which many cases present. Attention is therefore focusing on preventative strategies for colorectal cancer given that polyps appear to be identifiable and treatable precursor lesions of this disease. Endoscopic polypectomy has been shown to reduce the incidence of colorectal cancer and there is a good case for endoscopic screening of the general population. However, this will require a large amount of manpower and resources and its success will also depend on the overall compliance of the population. Epidemiological studies have shown that individuals reporting a regular intake of aspirin and other non-steroidal anti-inflammatory drugs have a reduced risk of developing colorectal polyps and cancer. Similarly, a number of natural substances, such as calcium and folate, when supplemented regularly in the diet, have also been linked to a possible decreased incidence of colorectal cancer. This has led to the concept of using such agents to reduce the number of cases of colorectal cancer. In this article, we review the current evidence for the use of these and other agents for the chemoprevention of colorectal cancer, together with theories as to their possible mechanisms of action.
Courtney
E D J
ED
Gastroenterology Medicine Division, St George's Hospital Medical School, London, UK. edjcourtney@hotmail.com
Melville
D M
DM
Leicester
R J
RJ
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D018890:Chemoprevention / Q000379:methods*; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004043:Dietary Fiber; D000518:Eflornithine / Q000627:therapeutic use; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D008017:Life Expectancy; D008403:Mass Screening / Q000379:methods; D012643:Selenium / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D004043:Dietary Fiber; D014580:Ursodeoxycholic Acid; D005492:Folic Acid; D066246:ErbB Receptors; D012643:Selenium; D002118:Calcium; D000518:Eflornithine