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Prevention of colorectal cancer by combining early detection and chemoprevention

  • Published:
Current Colorectal Cancer Reports

Abstract

Colorectal cancer is a major cause of cancer-related mortality. Most colorectal cancers arise in precursor lesions over a number of years. The carcinogenetic pathway is modulated by a wide array of genetic and epigenetic factors. Two major approaches to halting carcinogenesis are chemoprevention and early detection. Chemoprevention is an attractive emerging option—advances in understanding the carcinogenetic pathways and progress in evaluating various putative agents are promising. However, several issues regarding efficacy, safety, and acceptability require answers before an ideal agent can come into widespread use. Early detection and removal of precursor lesions show promise in reducing disease burden. Although the concept has been around and has been widely advocated for several years, participation in screening remains low. The ideal test in terms of practicality, accuracy, and safety is still debated. This article reviews the recent literature related to screening and chemoprevention of colorectal cancer.

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References and Recommended Reading

  1. SEER Cancer Statistics Review, 1975–2005, National Cancer Institute. Available at http://seer.cancer.gov/csr/1975_2005. Accessed September 2008.

  2. McGregor SE, Hilsden RJ, Li FX, et al.: Low uptake of colorectal cancer screening 3 yr after release of national recommendations for screening. Am J Gastroenterol 2007, 102:1727–1735.

    Article  PubMed  Google Scholar 

  3. Lamerato LE, Marcus PM, Jacobsen G, Johnson CC: Recruitment in the prostate, lung, colorectal, and ovarian (PLCO) cancer screening trial: the first phase of recruitment at Henry Ford Health System. Cancer Epidemiol Biomarkers Prev 2008, 17:827–833.

    Article  PubMed  Google Scholar 

  4. Murff HJ, Peterson NB, Fowke JH, et al.: Colonoscopy screening in African Americans and Whites with affected first-degree relatives. Arch Intern Med 2008, 168:625–631.

    Article  PubMed  Google Scholar 

  5. Goldsmith G, Chiaro C: Colorectal cancer screening: how to help patients comply. J Fam Pract 2008, 57:E2–E7.

    PubMed  Google Scholar 

  6. Cole SR, Smith A, Wilson C, et al.: An advance notification letter increases participation in colorectal cancer screening. J Med Screen 2007, 14:73–75.

    Article  PubMed  CAS  Google Scholar 

  7. Christie J, Itzkowitz S, Lihau-Nkanza I, et al.: A randomized controlled trial using patient navigation to increase colonoscopy screening among low-income minorities. J Natl Med Assoc 2008, 100:278–284.

    PubMed  Google Scholar 

  8. Ruffin MT 4th, Fetters MD, Jimbo M: Preference-based electronic decision aid to promote colorectal cancer screening: results of a randomized controlled trial. Prev Med 2007, 45:267–273.

    Article  PubMed  Google Scholar 

  9. Lindholm E, Brevinge H, Haglind E: Survival benefit in a randomized clinical trial of faecal occult blood screening for colorectal cancer. Br J Surg 2008, 95:1029–1036.

    Article  PubMed  CAS  Google Scholar 

  10. Hewitson P, Glasziou P, Irwig L, et al.: Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database Syst Rev 2007, 1:CD001216.

    PubMed  Google Scholar 

  11. Goodyear SJ, Leung E, Menon A, et al.: The effect of population-based faecal occult blood test screening upon emergency colorectal cancer admissions in Coventry and north Warwickshire. Gut 2008, 57:218–222.

    Article  PubMed  CAS  Google Scholar 

  12. Levin B, Lieberman DA, McFarland B, et al.: Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology 2008, 134:1570–1595.

    Article  PubMed  CAS  Google Scholar 

  13. van Rossum LG, van Rijn AF, Laheij RJ, et al.: Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology 2008, 135:82–90.

    Article  PubMed  Google Scholar 

  14. Shastri YM, Loitsch S, Hoepffner N, et al.: Comparison of an established simple office-based immunological FOBT with fecal tumor pyruvate kinase type M2 (M2-PK) for colorectal cancer screening: prospective multicenter study. Am J Gastroenterol 2008, 103:1496–1504.

    Article  PubMed  CAS  Google Scholar 

  15. Heresbach D, Barrioz T, Lapalus MG, et al.: Miss rate for colorectal neoplastic polyps: a prospective multicenter study of back-to-back video colonoscopies. Endoscopy 2008, 40:284–290.

    Article  PubMed  CAS  Google Scholar 

  16. Singh H, Turner D, Xue L, et al.: Risk of developing colorectal cancer following a negative colonoscopy examination: evidence for a 10-year interval between colonoscopies. JAMA 2006, 295:2366–2373.

    Article  PubMed  CAS  Google Scholar 

  17. Becker F, Nusko G, Welke J, et al.: Benefit-risk analysis of different risk-related surveillance schedules following colorectal polypectomy. Hepatogastroenterology 2007, 54:2249–2258.

    PubMed  CAS  Google Scholar 

  18. Rosman AS, Korsten MA: Meta-analysis comparing CT colonography, air contrast barium enema, and colonoscopy. Am J Med 2007, 120:203–210.

    Article  PubMed  Google Scholar 

  19. Sosna J, Sella T, Sy O, et al.: Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography. AJR Am J Roentgenol 2008, 190:374–385.

    Article  PubMed  Google Scholar 

  20. Brenner H, Hoffmeister M, Stegmaier C, et al.: Risk of progression of advanced adenomas to colorectal cancer by age and sex: estimates based on 840,149 screening colonoscopies. Gut 2007, 56:1585–1589.

    Article  PubMed  Google Scholar 

  21. Rundle AG, Lebwohl B, Vogel R, et al.: Colonoscopic screening in average-risk individuals ages 40 to 49 vs 50 to 59 years. Gastroenterology 2008, 134:1311–1315.

    Article  PubMed  Google Scholar 

  22. Brown SR, Baraza W, Hurlstone P: Chromoscopy versus conventional endoscopy for the detection of polyps in the colon and rectum. Cochrane Database Syst Rev 2007, 4:CD006439.

    PubMed  Google Scholar 

  23. Triadafilopoulos G, Li J: A pilot study to assess the safety and efficacy of the Third Eye retrograde auxiliary imaging system during colonoscopy. Endoscopy 2008, 40:478–482.

    Article  PubMed  CAS  Google Scholar 

  24. Dekker E, van den Broek FJ, Reitsma JB, et al.: Narrowband imaging compared with conventional colonoscopy for the detection of dysplasia in patients with longstanding ulcerative colitis. Endoscopy 2007, 39:216–221.

    Article  PubMed  CAS  Google Scholar 

  25. van den Broek FJ, Fockens P, van Eeden S, et al.: Endoscopic tri-modal imaging for surveillance in ulcerative colitis: randomised comparison of high-resolution endoscopy and autofluorescence imaging for neoplasia detection; and evaluation of narrow-band imaging for classification of lesions. Gut 2008, 57:1083–1089.

    Article  PubMed  Google Scholar 

  26. Hassan C, Zullo A, Winn S, et al.: Cost-effectiveness of capsule endoscopy in screening for colorectal cancer. Endoscopy 2008, 40:414–421.

    Article  PubMed  CAS  Google Scholar 

  27. Kelloff GJ, Lippman SM, Dannenberg AJ, et al.: Progress in chemoprevention drug development: the promise of molecular biomarkers for prevention of intraepithelial neoplasia and cancer-a plan to move forward. Clin Cancer Res 2006, 12:3661–3697.

    Article  PubMed  CAS  Google Scholar 

  28. Leman ES, Schoen RE, Magheli A, et al.: Evaluation of colon cancer-specific antigen 2 as a potential serum marker for colorectal cancer. Clin Cancer Res 2008, 14:1349–1354.

    Article  PubMed  CAS  Google Scholar 

  29. Hundt S, Haug U, Brenner H: Blood markers for early detection of colorectal cancer: a systematic review. Cancer Epidemiol Biomarkers Prev 2007, 16:1935–1953.

    Article  PubMed  CAS  Google Scholar 

  30. Kim YI: Folate and colorectal cancer: an evidence-based critical review. Mol Nutr Food Res 2007, 51:267–292.

    Article  PubMed  CAS  Google Scholar 

  31. Vinikoor LC, Robertson DJ, Baron JA, et al.: Cholecystectomy and the risk of recurrent colorectal adenomas. Cancer Epidemiol Biomarkers Prev 2007, 16:1523–1525.

    Article  PubMed  Google Scholar 

  32. Issa AY, Volate SR, Muga SJ, et al.: Green tea selectively targets initial stages of intestinal carcinogenesis in the AOMApcMin mouse model. Carcinogenesis 2007, 28:1978–1984.

    Article  PubMed  CAS  Google Scholar 

  33. Rijcken FE, Hollema H, van der Zee AG, et al.: Sulindac treatment in hereditary non-polyposis colorectal cancer. Eur J Cancer 2007, 43:1251–1256.

    Article  PubMed  CAS  Google Scholar 

  34. Lou J, Fatima N, Xiao Z, et al.: Proteomic profiling identifies cyclooxygenase-2-independent global proteomic changes by celecoxib in colorectal cancer cells. Cancer Epidemiol Biomarkers Prev 2006, 15:1598–1606.

    Article  PubMed  CAS  Google Scholar 

  35. Gao J, Kashfi K, Liu X, Rigas B: NO-donating aspirin induces phase II enzymes in vitro and in vivo. Carcinogenesis 2006, 27:803–810.

    Article  PubMed  CAS  Google Scholar 

  36. Hagos GK, Abdul-Hay SO, Sohn J, et al.: Anti-inflammatory, antiproliferative, and cytoprotective activity of NO chimera nitrates of use in cancer chemoprevention. Mol Pharmacol 2008, [Epub ahead of print].

  37. Fujisawa T, Nakajima A, Fujisawa N, et al.: Peroxisome proliferator-activated receptor gamma (PPARgamma) suppresses colonic epithelial cell turnover and colon carcinogenesis through inhibition of the beta-catenin/T cell factor (TCF) pathway. J Pharmacol Sci 2008, 106:627–638.

    Article  PubMed  CAS  Google Scholar 

  38. Lanza E, Yu B, Murphy G, et al.: The polyp prevention trial continued follow-up study: no effect of a low-fat, high-fiber, high-fruit, and -vegetable diet on adenoma recurrence eight years after randomization. Cancer Epidemiol Biomarkers Prev 2007, 16:1745–1752.

    Article  PubMed  Google Scholar 

  39. Baron JA, Sandler RS, Bresalier RS, et al.: A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas. Gastroenterology 2006, 131:1674–1682.

    Article  PubMed  CAS  Google Scholar 

  40. Rubin DT, Cruz-Correa MR, Gasche C, et al.: Colorectal cancer prevention in inflammatory bowel disease and the role of 5-aminosalicylic acid: a clinical review and update. Inflamm Bowel Dis 2008, 14:265–274.

    Article  PubMed  Google Scholar 

  41. Bonovas S, Filioussi K, Flordellis CS, Sitaras NM: Statins and the risk of colorectal cancer: a meta-analysis of 18 studies involving more than 1.5 million patients. J Clin Oncol 2007, 25:3462–3468.

    Article  PubMed  Google Scholar 

  42. Dubé C, Rostom A, Lewin G, et al.: The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med 2007, 146:365–375.

    PubMed  Google Scholar 

  43. Rostom A, Dubé C, Lewin G, et al.: Nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med 2007, 146:376–389.

    PubMed  Google Scholar 

  44. Hoffmeister M, Chang-Claude J, Brenner H: Individual and joint use of statins and low-dose aspirin and risk of colorectal cancer: a population-based case-control study. Int J Cancer 2007, 121:1325–1330.

    Article  PubMed  CAS  Google Scholar 

  45. Jankowski JA, Moayyedi P: Aspirin as chemoprevention for Barrett’s esophagus: a large RCT underway in the UK. J Natl Cancer Inst 2004, 96:885–887.

    Article  PubMed  CAS  Google Scholar 

  46. Yang K, Lamprecht SA, Shinozaki H, et al.: Dietary calcium and cholecalciferol modulate cyclin D1 expression, apoptosis, and tumorigenesis in intestine of adenomatous polyposis coli1638N/+ mice. J Nutr 2008, 138:1658–1663.

    PubMed  CAS  Google Scholar 

  47. Millen AE, Subar AF, Graubard BI, et al.: Fruit and vegetable intake and prevalence of colorectal adenoma in a cancer screening trial. Am J Clin Nutr 2007, 86:1754–1764.

    PubMed  CAS  Google Scholar 

  48. Martínez ME, Jacobs ET, Ashbeck EL, et al.: Meat intake, preparation methods, mutagens and colorectal adenoma recurrence. Carcinogenesis 2007, 28:2019–2027.

    Article  PubMed  CAS  Google Scholar 

  49. Courtney ED, Matthews S, Finlayson C, et al.: Eicosapentaenoic acid (EPA) reduces crypt cell proliferation and increases apoptosis in normal colonic mucosa in subjects with a history of colorectal adenomas. Int J Colorectal Dis 2007, 22:765–776.

    Article  PubMed  CAS  Google Scholar 

  50. Second Expert Report: Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. Available at: http://www.dietandcancerreport.org/downloads/chapters/ chapter_07.pdf. Accessed October 2008.

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Correspondence to Janusz Jankowski.

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Das, D., Jankowski, J. Prevention of colorectal cancer by combining early detection and chemoprevention. Curr colorectal cancer rep 5, 48–54 (2009). https://doi.org/10.1007/s11888-009-0008-7

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