| Abstract: |
This article reviews the current status of the pharmacological prevention of colorectal cancer (CRC). The authors note that CRC tends to develop through a multistep process that occurs over a period of years, permitting many opportunities for intervention and cancer prevention. The authors briefly discuss the natural history of adenomatous polyps and CRC, as well as the identification of individuals at risk for CRC, and address the use of chemoprevention. Chemoprevention involves the long-term use of nutritional or pharmaceutical agents that can delay, prevent, or even reverse the process of CRC development. The authors discuss the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as well as a new group of agents, the nitric-oxide-releasing NSAIDs (NO-NSAIDs). Other drugs discussed include HMG-CoA reductase inhibitors (statins), ursodeoxycholic acid, difluromethaylornitine (DMFO), and hormone replacement therapy (HRT). They note that, at present, the only approved drug for chemoprevention of CRC is celecoxib and that is indicated only in high-risk patients with familial adenomatous polyposis (FAP). Screening methods and surveillance continue to be the standard of care for high-risk patients with a history of CRC or adenomatous polyps and for the general population based on age. 64 references. |