ABSTRACT
CONTENTS Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 Colorectal Cancer Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 Preventative Strategies Targeting Early Lesions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288 Role of Prebiotics in Colorectal Cancer Prevention . . . . . . . . . . . . . . . . . . . . . . . . . 288 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 292
Cancer deaths and new cancer cases continue to mount at an alarming rate. While it is estimated that the current death rate of approximately 7 million annually may decline, the ca. 20 million new cases is projected to increase to 30 million in the next 10 years, unless effective prevention strategies are implemented. The most effective strategy may be to actively manage the disease via screening, early detection, introduction of healthy diets, and other life style changes and use of more sophisticated interventions (drug and dietary) in high risk groups of individuals. In developed countries, cancer is the second-biggest cause of death after cardiovascular disease (CVD) and epidemiological evidence points to this trend emerging in the developed parts of the world.1-3 This is particularly true for countries of “transition” or in the middle income category, such as in South America and Asia. Today, more than half of all cancer cases occur in developing countries. Dietary factors are estimated to account for approximately 30% of cancers in western countries, making diet second only to tobacco as a preventable cause of cancer.4
However, it is increasingly apparent that not all individuals will respond identically to dietary change.5
