Abstract
Morbidity and mortality from colorectal cancer (CRC) can be effectively reduced through
early detection and prevention. To date, strategies for managing CRC risk have focused
primarily on secondary prevention, through screening asymptomatic individuals for
colorectal neoplasia. In the United States, implementation of screening among individuals
age ≥50 has led to not only decreased CRC-related mortality but also reduced CRC incidence
through colonoscopic removal of precancerous polyps. In contrast to screening's endpoint
of early detection, the goal of primary prevention of CRC is to arrest and/or reverse
colorectal carcinogenesis. Observational studies and randomized clinical trials continue
to examine effects of specific pharmacologic agents (chemoprevention) and dietary
interventions on development of advanced colorectal neoplasia. This review will present
an overview of strategies for primary and secondary prevention of CRC, including endoscopic,
pharmacologic, and dietary interventions.
Keywords
primary prevention - colorectal cancer - chemoprevention - colonoscopy
