Chemoprevention for Colorectal Cancer: What Works and What Doesn’t?
Douglas K. Rex, MD, MASGE, reviewing Chapelle N, et al. Gut 2020 Sep 28.
This was a systematic review of 80 meta-analyses of colorectal cancer prevention with medications, vitamins, supplements, and dietary factors.
Of the factors found to be effective, the strongest evidence is for aspirin, including doses as low as 75 mg, but there is also evidence for nonsteroidal anti-inflammatory drugs and magnesium. There is very low evidence for folic acid, dairy products, fiber, and diets rich in fruits and vegetables. Factors with unclear or mixed protective effects include tea, coffee, garlic, fish, and soy products, as well as vitamin E, vitamin C, beta carotene, selenium, vitamin D, calcium, and statins.
Factors associated with increased risk include meat intake and alcohol consumption.
COMMENTIn the recovery area after colonoscopy, we are often asked about ways to reduce polyp and cancer risk. This paper is a good source for updating information provided to patients.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Chapelle N, Martel M, Toes-Zoutendijk E, Barkun AN, Bardou M. Recent advances in clinical practice: colorectal cancer chemoprevention in the average-risk population. Gut 2020 Sep 28. (Epub ahead of print) (http://dx.doi.org/10.1136/gutjnl-2020-320990)
