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The Role of Aspirin, Vitamin D, Exercise, Diet, Statins, and Metformin in the Prevention and Treatment of Colorectal Cancer

  • Lower Gastrointestinal Cancers (AB Benson, Section Editor)
  • Published:
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Opinion statement

Colorectal cancer (CRC) is a worldwide health problem leading to significant morbidity and mortality. Several strategies based on either lifestyle modifications or pharmacological interventions have been developed in an attempt to reduce the risk of CRC. In this review article, we discuss these interventions including aspirin (and other non-steroidal anti-inflammatory drugs), vitamin D, exercise, diet, statins, and metformin. Depending upon the risk of developing CRC, the current evidence supports the beneficial role of aspirin, vitamin D, diet, and exercise especially in high-risk individuals (advanced adenoma or CRC). However, even with these established interventions, there are significant knowledge gaps such as doses of aspirin and 25-hydroxy vitamin D are not well established. Similarly, there is no convincing data from randomized controlled trials that a high fiber diet or a low animal fat diet reduces the risk of CRC. Some potential interventions, such as statins and metformin, do not have convincing data for clinical use even in high-risk individuals. However, these may have emerging roles in the prevention and treatment of CRC. Greater understanding of molecular mechanisms and the application of genomic tools to risk stratify an individual and tailor the interventions based on that individual’s risk will help further advance the field. Some of this work is already underway and is a focus of this article.

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Abbreviations

CRC:

Colorectal cancer

RR:

Relative risk

OR:

Odds ratio

CI:

Confidence interval

NSAID:

Non-steroidal anti-inflammatory drugs

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Amikar Sehdev and Bert H. O’Neil declare that they have no conflict of interest.

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  1. Division of Hematology Oncology, Department of Medicine, Indiana University, 535 Barnhill Dr., RT 130B, Indianapolis, IN, 46202, USA

    Amikar Sehdev MD, MPH

  2. Division of Hematology Oncology, Indiana University, Indianapolis, IN, USA

    Bert H. O’Neil MD

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  1. Amikar Sehdev MD, MPH
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Correspondence to Amikar Sehdev MD, MPH.

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This article is part of the Topical Collection on Lower Gastrointestinal Cancers

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Sehdev, A., O’Neil, B.H. The Role of Aspirin, Vitamin D, Exercise, Diet, Statins, and Metformin in the Prevention and Treatment of Colorectal Cancer. Curr. Treat. Options in Oncol. 16, 43 (2015). https://doi.org/10.1007/s11864-015-0359-z

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