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Colorectal Cancer Prevention

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Fundamentals of Cancer Prevention

Abstract

Colorectal cancer (CRC) is the second commonest fatal cancer in developed countries. Early-onset CRC incidence in individuals aged <50 years is rising steadily. Histological stage at diagnosis determines CRC prognosis. Genetic instability, either chromosomal or microsatellite instability, underlies most cases. CRCs arise from benign adenomatous polyps and sessile serrated adenomas. Physical inactivity and diet are risk factors, linked through obesity-related metabolic disturbance causing chronic inflammation. Distinct from the autosomal dominantly inherited familial forms of CRC, a family history of CRC in first-degree relatives increases risk of CRC. Ulcerative and Crohn’s colitis and cystic fibrosis increase CRC risk. Prolonged aspirin use reduces CRC risk. Screening substantially reduces CRC mortality in the older population through subsequent adenoma removal and treatment of early-stage CRCs in screen-positive individuals; accepted modalities include fecal blood tests, flexible sigmoidoscopy, colonoscopy, and computed tomographic colonography. Despite much research, chemoprevention for CRC has yet to enter clinical practice.

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Lance, P. (2019). Colorectal Cancer Prevention. In: Alberts, D., Hess, L. (eds) Fundamentals of Cancer Prevention. Springer, Cham. https://doi.org/10.1007/978-3-030-15935-1_14

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