National and international geographic variations in the incidence and
mortality rates of colorectal cancer along with changes in prevalence
among migrant populations would suggest that environmental factors hav
e a role in the aetiology of this disease. Animal models of chemically
induced colonic carcinogenesis have been widely used to assess the ef
fect of dietary components such as fat and fibre. These studies have s
hown that the type of fat is important. Polyunsaturated vegetable oils
rich in omega-6 fatty acids have a promotional role whereas fish oil
rich in omega-3 fatty acids has no promotional effect and may even inh
ibit tumour formation. Studies of the effect of fibres have shown that
insoluble dietary fibres such as wheat bran and cellulose may have a
protective role. However, soluble fibres such as pectin and psyllium o
ffer little protection and in fact carrageenan may have a promotional
effect. It has been suggested that phytic acid (inosital hexaphosphate
), a component of many fibre-rich diets, rather than fibre per se, has
a role in the suppression of colonic carcinogenesis. Despite conflict
ing evidence, it may be plausible to advocate a high fibre, low fat di
et as a measure of secondary prevention of colorectal cancer.