Abstract
Epidemiological studies have emphasised the major role of diet in the aetiology of large bowel cancer. Attempts to identify causative or protective factors in epidemiological and experimental studies have led to some discrepancies. The time has come to test the most important hypotheses within the framework of intervention studies. Among studies specifically devoted to colorectal carcinogenesis, eight have been completed and five are ongoing. They evaluate the effect of the intervention on adenoma recurrence and, in three studies, on adenoma growth. Five intervention trials considering cardiovascular diseases and different cancer sites will provide data on the effect of the intervention on colorectal cancer incidence. Vitamins and antioxidants, fibre or calcium supplementation, aspirin therapy and dietary modifications are evaluated. Most of the available data do not support the idea of a protective effect of vitamins and antioxidants against colorectal carcinogenesis. It is too early to draw any conclusions on the effects of fibre, calcium supplementation, aspirin therapy and dietary intervention. The results of ongoing studies will be available within 2 years. If one of the evaluated interventions proves efficient, the benefits of a simple, safe and inexpensive prophylaxis for a very common cancer will be clear.
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References
Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029–1035.
Baron JA, Tosteson TD, Wargovich MJ (1995) Calcium supplementation and rectal mucosal proliferation: a randomized controlled trial. J Natl Cancer Inst 87:1303–1307.
Berrino F, Sant M, Verdecchia A, Capocaccia R, Hakulinen T, Esteve J (1995) Survival of cancer patients in Europa. The EUROCARE study. (IARC scientific publications no. 132). IARC, Lyon.
Bonelli L, Conio M, Picasso M, Massa P, Dodero M, Ravelli P, Missale G, Bruzzi P, Aste H (1994) Chemoprevention of metachronous adenomas of the large bowel: a double blind randomized trial of antioxidants (abstract), 3rd United European Gastroenterology Week, Oslo, abstract book, A 61.
Bussey HJR, De Cosse JJ, Deschner EE, Eyers AA, Lesser ML, Morson BC, Ritchie SM, Thmas JPS, Wadsworth JA (1982) Randomized trial of ascorbic acid in polyposis coli cancer. Cancer 50:1434–1439.
De Cosse J J, Miller HH, Lesser ML (1989) Effect of wheat fiber and vitamin C and E on rectal polyps in patients with familial adenomatous polyposis. J Natl Cancer Inst 81:1290–1297.
Faivre J, Wilpart M, Boutron MC (1991) Primary prevention of large bowel cancer. Recent Results Cancer Res 122:85–99.
Faivre J, Couillault C, Kronborg O, Rath U, Giacosa A, De Oliveira H, Obrador T, O’Morain C, ECP Colon Group (1997) Chemoprevention of metachronous adenomas of the large bowel; design and interim results of a randomized trial of calcium and fibre. Eur J Cancer Prev 6:132–138.
Freedman LS, Schatzkin A (1992) Sample size for studying intermediate end points within intervention trials or observational studies. Am J Epidemiol 136:1148–1159.
Gann PH, Manson JE, Glynn RJ (1993) Low-dose aspirin and incidence of colorectal tumours in a randomized trial. J Natl Cancer Inst 85:1220–1224.
Greenberg ER, Baron JA, Tosteson TD, Freeman DM, Beck GJ, Bond JH, Colacchio TA, Coller JA, Frankl HD, Haile RW, Mandel JS, Nierenberg DW, Rothstein R, Snover DC, Stevens MM, Summers RW, Van Stolk RU (1994) A clinical trial of antioxidant vitamins to prevent colorectal adenoma. N Engl J Med 331:141–147.
Hennekens CH, Buring JF, Manson JE et al. (1996) Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 334:1145–1149.
Hercberg S, Briancon S, Favier A (1993) Le projet SUVIMAX/100000 volontaires pour la recherche en nutrition dans le domaine de la prevention. Cah Nutr Diet 1:55–64.
Hofstad B, Vatn M, Hoff G, Larsen S, Osnes M (1992) Growth of colorectal polyps: design of a prospective, randomized, placebo-controlled intervention study in patients with colorectal polyps. Eur J Cancer Prev 1:415–422.
Hofstad B, Almenningen K, Vatn M, Norheim Andersen S, Owen RW, Larsen S, Osnes M (1995) Effect of calcium and antioxydants on growth of colorectal polyps (abstract). Gut 37:A34.
McKeown-Eyssen G, Holloway C, Jazmaji V, Bright-See E, Dion P, Bruce WR (1988) A randomized trial of vitamins C and E in the prevention of recurrence of colorectal polyps. Cancer Res 48:4701–4705.
McKeown-Eyssen GE, Bright-See E, Bruce WR, Jazmaji V, Toronto Polyp Prevention Group (1994) A randomized trial of a low fat high fibre diet in the recurrence of colorectal polyps. J Clin Epidemiol 47:525–536.
MacLennan R, Bain C, Macrae F, Gratten H, Battistutta D, Bokey EL, Chapuis P, Goulston K, Lambert J, Wahlquist H, Ward M (1991) Design and implementation of the Australian polyp prevention project. Front Gastrointest Res 18:60–73.
MacLennan R, Macrae FA, Bain C, Battistutta D, Chapuis P, Gratten H (1995) Randomized trial of intake of fat, fiber and beta carotene to prevent colorectal adenomas. J Natl Cancer Inst 87:1760–1766.
Ommen GS, Goodman GE, Thornquist MD et al. (1996) Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med 334:1150–1155.
Parkin DM, Pisani P, Ferlay J (1993) Estimates of the worldwide incidence of eighteen major cancers in 1985. Int J Cancer 54:94–606.
Potter JD, Slattery ML, Bostick RM, Gapstur SM (1993) Colon cancer: a review of the epidemiology. Epidemiol Rev 15:499–545.
Roncucci L, Di Donato P, Carati L, Ferrari A, Perini M, Bertoni G, Bedogni G, Paris B, Svanoni F, Girola M, Ponz de Léon M (1993) Antioxidant vitamines or lactulose for the prevention of the recurrence of colorectal adenomas. Dis Colon Rectum 36:227–234.
Rooney PS, Gifford KA, Clarke PA, Hardcastle JD, Armitage NC (1994) A double-blind randomized controlled of dietary calcium supplementation in individuals with adenomas (one-year results) (abstract). Dis Colon Rectum 37:P41.
Vargas PA, Alberts DS (1992) Primary prevention of colorectal cancer through dietary modification. Cancer 70:1229–1235.
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Faivre, J., Bonithon-Kopp, C. (1999). Chemoprevention of Colorectal Cancer. In: Senn, HJ., Costa, A., Jordan, V.C. (eds) Chemoprevention of Cancer. Recent Results in Cancer Research, vol 151. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59945-3_9
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DOI: https://doi.org/10.1007/978-3-642-59945-3_9
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