The Adenoma-Carcinoma Sequence and Prospects for the Prevention of Colorectal Neoplasia
- 1 January 1996
- journal article
- review article
- Published by Begell House in Critical Reviews™ in Oncogenesis
- Vol. 7 (5-6) , 293-342
- https://doi.org/10.1615/critrevoncog.v7.i5-6.10
Abstract
Colorectal adenomatous polyps are thought to be precursors of colorectal cancer. This article reviews the evidence for the adenoma-carcinoma sequence and possible interventions in regard to the prevention of colorectal cancer. Although there is no direct evidence to support the adenoma-carcinoma sequence, there is considerable indirect evidence from a range of epidemiological, histopathological, and molecular genetic studies. Sigmoidoscopy and fecal occult blood testing may offer the potential for secondary prevention, but screening based on either of these methods in the general population has not yet been shown conclusively to be effective and efficient. Although the importance of dietary factors in the etiology of colorectal lesions suggests that there may be potential for primary prevention through dietary modification or nutrient supplementation, few trials have been completed to date. Although observational studies suggest that the incidence of colorectal cancer may be reduced by as much as 50% by the use of aspirin or other nonsteroidal antiinflammatory drugs (NSAIDs), further research is needed to determine the effects of individual NSAIDs and the appropriate prophylactic dose and to develop new NSAIDs with reduced gastrointestinal side-effects. Other strategies for primary prevention could focus on interventions to increase physical activity levels, to encourage smoking cessation, and to moderate alcohol consumption. Potential areas for further research are proposed.Keywords
This publication has 7 references indexed in Scilit:
- Colorectal cancer risk, chronic illnesses, operations and medications: case control results from the Melbourne Colorectal Cancer StudyInternational Journal of Epidemiology, 2007
- Nonsteroidal anti-inflammatory drug use and protection against colorectal cancer in women1996
- Physical Activity, Obesity, and Risk for Colon Cancer and Adenoma in MenAnnals of Internal Medicine, 1995
- Aspirin Use and the Risk for Colorectal Cancer and Adenoma in Male Health ProfessionalsAnnals of Internal Medicine, 1994
- Dietary Risk Factors for the Incidence and Recurrence of Colorectal Adenomatous Polyps: A Case-Control StudyAnnals of Internal Medicine, 1993
- Effect of Fecal Occult Blood Testing on Mortality from Colorectal Cancer: A Case–Control StudyAnnals of Internal Medicine, 1993
- Screening Sigmoidoscopy and Colorectal Cancer MortalityJNCI Journal of the National Cancer Institute, 1992