Journal Article

Nutritional prevention of colorectal cancer

Hull, Mark A.

2021

Overview

The preventability estimate for colorectal cancer (CRC) is approximately 50%, highlighting the huge potential for altering modifiable lifestyle factors (including diet and body fatness) in order to reduce risk of this common malignancy. There is strong evidence that dietary factors (including intake of wholegrains, fibre, red and processed meat and alcohol) affect CRC risk. The lack of positive intervention trials and limited mechanistic understanding likely explain limited public health impact of epidemiological observations, to date. An alternative strategy for nutritional prevention of CRC is use of supplements that provide higher individual nutrient exposure than obtained through the diet (chemoprevention). There are positive data for calcium and/or vitamin D and the n-3 fatty acid EPA from polyp prevention trials using colorectal adenoma as a CRC risk biomarker. Although CRC is an obesity-related malignancy, there remains a paucity of observational data supporting intentional weight loss for CRC risk reduction. Some types of obesity surgeries (Roux-en-Y gastric bypass) might actually increase subsequent CRC risk due to alteration of local intestinal factors. There is intense interest in nutritional therapy of patients after diagnosis of CRC, in order to impact on recurrence and overall survival (now often termed cancer interception). In conclusion, nutritional prevention of CRC continues to hold much promise. Increased mechanistic understanding of the role of individual nutrients (linked to intestinal microbiota), as well as a precision medicine approach to CRC chemoprevention and interception based on both tumour and host factors, should enable translation of nutritional interventions into effective CRC risk reduction measures.

• Publisher: Cambridge University Press
• Subject: Adenoma / Alcohol use / alcohols / Aspirin / bariatric surgery / Biomarkers / Body weight loss / Calcium / Cancer / chemoprevention / Clinical trials / Colonoscopy / Colorectal cancer / Colorectal carcinoma / colorectal neoplasms / Conference on ‘Diet and Digestive Disease’ / Diet / Dietary intake / Dietary supplements / Disease prevention / Drug dosages / Endoscopy / Epidemiology / Fatty acids / Functional foods & nutraceuticals / Gastric bypass / Interception / Intervention / Intestinal microflora / intestinal microorganisms / Intestine / intestines / lifestyle / Lifestyles / Malignancy / Meat / Medical research / Microbiota / Mortality / Nutrients / Nutrition Society Winter Meeting 2019 / Nutrition therapy / Obesity / observational studies / omega-3 fatty acids / Polyps / Population / Precision medicine / processed meat / Public health / risk / Risk factors / Risk management / risk reduction / Seafood / Surgery / Surveillance / Symposium 4: GI cancers, the role of nutrition in prevention, pathology and management / Tumors / Vitamin B / Vitamin D / Weight loss