Prevention of colorectal cancer: diet, chemoprevention, and lifestyle.

This article focuses on preventing the initiation and promotion of neoplastic growth in colon cancer, particularly with dietary measures. A goal of dietary epidemiology is to identify chemopreventive agents and strategies. The effects of diet are analyzed by observational approaches and experimental dietary, nutritional, or chemopreventive interventions. Short-term trials that alter intermediate biomarkers that are more sensitive than the adenoma to interventions may be necessary. The same logic needs to be applied to chemoprevention. Nonsteroidal anti-inflammatory drugs, calcium, and selenium have some individual effects that could be potentiated if added together. The current evidence is that the combined effect of all three agents is modest, compared with the effects of screening, or even those of smoking cessation.