Chemoprevention of colorectal cancer: Dietary and pharmacologic approaches

Colorectal cancer is a major cause of death in the United States, where it accounts for approximately 57,000 deaths per year, Thus, the prevention of this disease would have a significant impact on public health, Chemoprevent ion is defined as the use of natural or pharmacologic agents to disrupt the process of carcinogenesis, Substances explored as chemopreventive agents i n colorectal cancer include: (1) the nonsteroidal anti-inflammatory drugs ( NSAIDS), which may inhibit the evolution and formation of adenomas by their inhibition of cyclooxygenase and decrease of prostaglandin synthesis; (2) antioxidants, such as vitamin E or C, which may modulate carcinogenic subst ances; and (3)folate and calcium, which may interfere with tumor cell growt h and replication, Dietary intervention can be accomplished by decreasing f at intake and increasing fiber consumption, both of which have been linked to a lower incidence of colon cancer in multiple epidemiologic studies, Thi s field is continuing to evolve, Hopefully, ongoing research efforts will o ffer a better understanding of the role of these and other substances in ch emoprevention. This article summarizes the available data regarding dietary and pharmacologic approaches to colorectal cancer chemoprevention.