Colorectal cancer (CRC) is the third most prevalent
neoplasm worldwide and fourth most frequent reason of
cancer-related death throughout the world. About 70% of malignant
tumors are related to lifestyle and environmental factors, and better knowledge of their significance might reduce the prevalence of CRC. The
cyclooxygenase-2 (COX-2) inhibitory and other direct and indirect pathways of
aspirin are translated to inhibition proliferation and enhanced apoptosis of
cancer cells. Many studies showed the benefits of
aspirin in reducing the risk of CRC development,
cancer-related mortality and
adenoma prevalence rate in general population, but not in high risk populations. The role of
sulindac in CRC prevention is uncertain and the use of this drug is rather uncommon.
Celecoxib - COX-2 selective inhibitor- showed efficacy in decreasing of colon
adenoma recurrence only in some studies. The protective role of microelements is controversial. The beneficial effects of supplementation of
selenium,
calcium,
folic acid,
methionine,
antioxidant supplements and probiotics are still not certain. A high energy diet consisting of red meat, animal fat, highly processed foods and
unsaturated fats increases the risk of CRC. Carcinogenic role of fat and
cholesterol depends on increased production of primary
bile acids. The importance of milk and dairy products in CRC prevention is controversial. Fruits, vegetables and grain are considered to have protective effects against
adenoma and CRC. Excessive alcohol consumption, smoking, physical inactivity are considered as important CRC risk factors. This article briefly summarizes current state of knowledge about the role of pharmacological and dietary prevention of
colorectal cancer. Moreover, it indicates that despite many studies some aspects of this issue are not clear and require future studies.