Colorectal cancer chemoprevention--an overview of the science.
The development and dissemination of sophisticated detection technologies have recently exposed the high prevalence of preinvasive colorectal neoplasia in the adult U.S. population. Although cancer screening and surveillance provide opportunities for risk stratification, they achieve risk reduction only when coupled with effective interventions. This review surveys the lead compounds for colorectal cancer prevention and the measures by which they may be prioritized for clinical testing. Clinical trials remain the rate-limiting step in agent development, and novel trial designs are needed to hasten agent identification and testing for cancer prevention. Innovative research models include the nesting of prevention end points within cancer treatment trials and within trials testing promising preventive compounds intended for nononcologic indications.
Hawk
Ernest T
ET
Gastrointentinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute/NIH, EPN Suite 2141, 6130 Executive Boulevard, Bethesda, MD 20892-7317, USA. eh51p@nih.gov
Umar
Asad
A
Viner
Jaye L
JL
D018890:Chemoprevention; D015179:Colorectal Neoplasms / Q000235:genetics / Q000517:prevention & control*; D004032:Diet; D020022:Genetic Predisposition to Disease; D006801:Humans; D011315:Preventive Medicine / Q000379:methods*; D012106:Research