Abstract
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 pharmacologie 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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Boyle P, Zaridze D et al (1985) Descriptive epidemiology of colorectal cancer. Int J Cancer 36: 9–18
Clark JC, Collan Y et al (1985) Prevalence of polyps in an autopsy series from areas with varying incidence of large-bowel cancer. Int J Cancer 36: 179–186
DeCosse J, Miller H et al (1989) Effect of wheat fiber and vitamins C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 81: 1290–1297
Fearon ER, Vogelstein B (1990) A genetic model for colorectal tumorigenesis. Cell 61: 759–767
Greenberg ER, Baron JA et al (1993) Reduced risk of large bowel adenomas among aspirin users. J Natl Cancer Inst 85: 912–916
Greenberg ER, Baron JA et al (1994) A clinical trial of antioxidant vitamins to prevent colorectal adenoma. N Engl J Med 331: 141–147
Greenwald P (1992) Colon cancer overview. Cancer [Suppl] 70: 1206S - 1215S
Hanley AJG, Choi BCK et al (1995) Cancer mortality among Chinese migrants: a review. Int J Epidemiol 24: 255–265
Heath CWJ, Thun NU et al (1994) Nonsteroidal antiinflammatory drugs and human cancer. Cancer 74: 2885–2888
Hennekens CH, Buring JE (1994) Contributions of observational evidence and clinical trials in cancer prevention. Cancer 74: 2625–2629
McKeown-Eyssen G, Holloway C et al (1988) A randomized trial of vitamins C and E in the prevention of recurrence of colorectal polyps. Cancer Res 48: 4701–4705
McKeown-Eyssen GE, Bright-See E et al (1994) A randomized trial of a low-fat high- fibre diet in the recurrence of colorectal polyps. J Clin Epidemiol 47: 525–536
Mandel JS, Bond JH et al (1993) Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med 328: 1365–1371
Newcomb PA, Norfleet RG et al (1992) Screening sigmoidscopy and colorectal cancer mortality. J Natl Cancer Inst 84: 1572–1575
Rickert RR, Auerbach O et al (1979) Adenomatous lesions of the large bowel: an autopsy survey. Cancer 43: 1847–1857
Ries LAG, Miller BA et al (1994) Cancer Statistics Review: 1973–1991: Tables and Graphs, National Cancer Institute. Bethesda, MD, NIH publ no 94–2789
Schatzkin A, Freedman LS et al (1994) Interpreting precursor studies: what polyp trials tell us about large-bowel cancer. J Natl Cancer Inst 86: 1053–1057
Selby JV, Friedman GD et al (1992) A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 326: 653–657
Shimizu H, Mack TM et al (1987) Cancer of the gastrointestinal tract among Japanese and white immigrants in Los Angeles county. J Natl Cancer Inst 78: 223–228
Steinmetz K, Potter JD (1991a) Vegetables, fruit, and cancer. II. Mechanisms. Cancer Causes Control 2: 427–442
Steinmetz KA, Potter JD (1991b) Vegetables, fruit, and cancer. I. Epidemiology. Cancer Causes Control 2: 325–357
Willett W (1989) The search for the causes of breast and colon cancer. Nature 338: 389–394
Winawer SJ, Zauber AG et al (1993) Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 329: 1977–1981
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1996 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Greenberg, E.R. (1996). Preventing Colorectal Cancer. In: Kreuser, ED., Schlag, P.M. (eds) New Perspectives in Molecular and Clinical Management of Gastrointestinal Tumors. Recent Results in Cancer Research, vol 142. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80035-1_2
Download citation
DOI: https://doi.org/10.1007/978-3-642-80035-1_2
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-80037-5
Online ISBN: 978-3-642-80035-1
eBook Packages: Springer Book Archive