Last update:
12-Jun-2001

Arch Hellen Med, 17(6), November-December 2000, 566-575

REVIEW

Prevention of colorectal cancer

D.K. CHRISTODOULOU,¹ E.V. TSIANOS^1,2
1Department of Gastroenterology,
²Division of Internal Medicine, Medical School, University of Ioannina, Greece

Colorectal cancer is one of the leading causes of death from cancer all over the world. In Greece, it is fourth among causes of death from cancer. The prevention of colorectal cancer involves two steps: primary and secondary prevention. In primary prevention attempts are made to avoid new cases of colorectal cancer and in secondary prevention the aim is to eliminate the premalignant lesions and to make an early diagnosis of colorectal cancer at a surgically curable stage. In primary prevention the genetic factors which cause colorectal cancer are examined, such as mutant genes in the familial syndromes of adenomatous polyposis or non-polypoid colorectal cancer. In addition, recommendations are made for improvement of dietary habits (reduction of consumption of animal fat, red meat and alcohol, and increase of consumption of dietary fiber, fruits, vegetable, calcium and olive oil), management of obesity and elimination of smoking and exposure to asbestos. In secondary prevention all persons at average risk should be tested appropriately (i.e. adults over 50 years without a family history of colorectal cancer or any other risk factor). The recommended tests are digital rectal examination, fecal test for occult blood, sigmoidoscopy and even colonoscopy. In high-risk groups (those with a family history of cancer, a history of adenomatous polyps, inflammatory bowel disease or familial syndromes of polyposis or non-polypoid colorectal cancer) screening is started at an earlier age and is more intense. In the future, genetic testing for mutant genes may further contribute to the reduction of the mortality rate in those familial hereditary syndromes which cause colorectal cancer.

Key words: Colorectal cancer, Prevention, Screening.