Current status of colorectal cancer chemoprevention |
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Authors: | Elizabeth Half MD Frank A Sinicrope MD |
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Institution: | (1) Mayo Clinic and Mayo College of Medicine, 200 First Street SW, Rochester, MN 55905, USA |
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Abstract: | Chemoprevention refers to suppression or reversal of the carcinogenic process using pharmacologic or nutritional agents. Colorectal
carcinogenesis is a protracted, multistep process that offers opportunities for prevention. Aspirin and selective cyclooxygenase-2
inhibitors (coxibs) have been evaluated for the prevention of sporadic adenoma recurrence. Aspirin was shown to reduce adenoma
recurrence rates in patients with prior colorectal neoplasms; however, the optimal dosage remains unclear. Recent studies
of coxibs indicate that these agents are effective in reducing sporadic adenoma recurrence, but chronic use can result in
serious cardiovascular toxicity. These data underscore the need for chemopreventive agents with acceptable risk-to-benefit
ratios. In this regard, nitric-oxide-releasing aspirin shows chemopreventive efficacy in preclinical models and holds promise
for reduced toxicity in humans. Furthermore, ongoing chemoprevention trials are evaluating nutritional supplements, such as
folic acid and selenium, and results are eagerly awaited. |
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