Abstract
The high rates of colorectal cancer in many affluent countries and the rapid increase that occurs in migrants to these countries from countries where rates are low suggest the importance in causation of environmental factors, especially dietary. The relevant aspects of diet are not clear despite correlation, migrant, case-control, and cohort studies, and it appears unlikely that simply repeating these same types of studies will elucidate specific dietary risk factors and provide a rational basis for the primary prevention of colorectal cancer. Prevention trials that test putative factors based on epidemiologic and laboratory evidence could help resolve etiological issues as well as test the efficacy of interventions. Such trials are feasible with precursor colorectal adenoma as the outcome variable rather than adenocarcinoma. Diets or supplements that are shown to prevent adenomas would also be expected to prevent adenocarcinomas, but this would require further testing. If possible, prevention trials should be replicated with a variety of dietary interventions. This would be facilitated internationally, where the range of available and traditional food patterns for inclusion in trials is greater than within any single country. The goal of such research is the primary prevention of colorectal cancer.
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© 1990 Plenum Press, New York
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MacLennan, R. (1990). Rationale for Intervention Trials of Dietary Fiber and Adenomatous Polyps. In: Kritchevsky, D., Bonfield, C., Anderson, J.W. (eds) Dietary Fiber. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-0519-4_36
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DOI: https://doi.org/10.1007/978-1-4613-0519-4_36
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