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Arch Hellen Med, 23(6), November-December 2006, 547-559


Chemoprevention of colorectal cancer

11st Department of Medical Oncology, "St. Savvas" Anticancer-Oncologic Hospital, Athens
2Department of Biological Chemistry, Medical School, University of Athens, Athens, Greece

Colorectal cancer is among the leading causes of cancer-related deaths. Surgical resection combined with the use of evolving chemotherapeutic agents remains the only curative treatment, and the likelihood of cure is greater when the disease is detected at an earlier histological stage. Early detection is the goal of screening programs that use periodic examination of stool for occult blood and endoscopic examination of the bowel. An alternative approach to reducing mortality from colorectal cancer involves the long-term use of a variety of oral agents that can prevent neoplasms from developing. Such pharmacologic prevention, known as chemoprevention, is directed at preventing the development of adenomatous polyps and their subsequent progression to colorectal cancer. Recent observations suggest a number of potential targets for chemoprevention. Many agents promise potential benefit, but show only modest chemopreventive efficacy in clinical trials. The inhibition of the growth of pre-cancerous and cancerous cells without damage to normal cells is the ultimate aim of cancer treatment, and is of particular importance in chemoprevention studies, which may be long term in nature, involve healthy subjects and cause minimal toxicity. Cancer prevention is certain to be a significant focus of research and intervention in the coming years, propelled by the realization that it will become possible to identify both the individuals susceptible to specific cancers and the molecular targets that can alter or stop the carcinogenesis process. Pharmacologists and geneticists are collaborating to develop new chemoprevention agents designed to act on molecular targets linked to specific pre-malignant or predisposing conditions.

Key words: Chemoprevention, Colorectal cancer.

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