Manzano A and Pérez-Segura P
Sporadic colorectal cancer (CRC) represents 75% of the total of the CRC cases diagnosed and is the second leading cause of cancer death with a a 5-year survival rate of 62%. The development of colorectal cancer is a complex process involving multiple molecular pathways, since the formation of adenomas to the development of carcinoma in the digestive tract (the so-called “adenoma-carcinoma sequence”), in a process that can last several decades. Thus adenomas are considered a surrogate variable for the development of CRC in clinical trials. Although screening strategies (blood in stool, endoscopic and CT-colonoscopy) have supposed a great advance in the early detection of these tumours, they are associated with inconveniences such as their cost and associated morbidity. Moreover screening does not necessarily prevent the development of cancer or prevent mortality. Therefore, interest in primary prevention research has increased in recent years. In this regard, multiple attempts to modify lifestyle and dietary factors to try to reduce the incidence of cancer have been promoted. However, some studies, many of them observational or case-control, have yielded conflicting data. Consequently, in the past 20 years, chemoprevention studies have grown in importance.
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