Current concepts in colorectal cancer prevention

Authors: Thompson, Patricia A; Gerner, Eugene W

Source: Expert Review of Gastroenterology and Hepatology, Volume 3, Number 4, August 2009 , pp. 369-382(14)

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Abstract:

Colorectal cancer chemoprevention, or chemoprophylaxis, is a drug-based approach to prevent colorectal cancer. Preventing colorectal adenomas with currently available agents demonstrates the promise of pharmacologic strategies directed at critical regulatory pathways. However, agent toxicity, lesion breakthrough and competing efficacy from endoscopy procedures challenge population-based implementation. This article reviews the role of colorectal cancer chemoprevention in the context of existing screening and surveillance guidelines and practice. Emphasis is placed on the role of the colorectal adenoma as a cancer precursor and its surrogacy in assessing individual risk and for evaluating chemoprevention efficacy. We discuss the importance of risk stratification for identifying subjects at moderate-to-high risk for colorectal cancer who are most likely to benefit from chemoprevention at an acceptable level of risk.

Keywords: adenoma; chemoprevention; colon cancer; colonoscopy; colonoscopy; difluoromethylornithine; NSAID; polyps

Document Type: Research article

DOI: http://dx.doi.org/10.1586/egh.09.28

Affiliations: 1: The University of Arizona, Gastrointestinal Cancer Program, Arizona Cancer Center, 1515 North Campbell Avenue, Tucson, AZ 85724, USA

Publication date: 2009-08-01

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