Primary and Secondary Chemoprevention of Colorectal Cancer

Abstract

Chemoprevention of colorectal cancer is defined as the use of pharmacological, chemical, or specific dietary agents that are capable of interrupting the carcinogenic process; progression or frank malignancy. Primary chemoprevention occurs when these agents are made available to the population at large. Secondary chemoprevention is used for individuals at high risk. Review of multiple studies in both animal models treated with chemical carcinogens and in small groups of patients at high risk with familial polyposis, sporadic polyps, and ulcerative colitis suggest that secondary chemoprevention is feasible. The most likely candidate agents appear to be supplemental calcium, prostaglandin inhibitors and possibly vitamins C and E when coupled with wheat bran. As yet none of these agents have been sufficiently tested to warrant their use in primary chemoprevention. A prudent diet of low animal fat, high fiber and controlled total calories does not require any additional supplements for the average or low risk population.