Chemoprevention of colorectal neoplasia

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Colorectal cancer (CRC) is a major cause of morbidity and mortality worldwide, despite screening programmes for early diagnosis, improved treatment strategies and new chemotherapeutic agents.1 CRC remains a major cause of death, and this is driving the development of preventative strategies that include chemoprevention to reduce the global burden associated with this disease.
Chemoprevention is defined as the use of natural or synthetic substances to reduce the risk of developing cancer or to reduce the risk of cancer recurrence.2 The first clinical CRC chemoprevention study was by Bussey et al.3 in 1982, who reported the results of a randomized trial in familial adenomatous polyposis (FAP) patients given ascorbic acid or placebo.3 Since then, numerous studies have evaluated the potential of over 200 agents to prevent development, aid regression and/or suppress recurrent precancerous adenomas as well as cancer,4 referred to as primary, secondary and tertiary chemoprevention, respectively. Ideally, a chemopreventative agent must be effective against more than one step in the carcinogenesis process.12 In addition, it should be easy to administer, accessible and cost effective.
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