Review provides a comprehensive summary of CRC epidemiology, with emphasis on modifiable lifestyle and nutritional factors, chemoprevention and screening. Overall, the optimal reduction of CRC incidence and mortality will require concerted efforts to reduce modifiable risk factors, to leverage chemoprevention research and to promote population-wide and targeted screening.
NaNa Keum (Harvard T.H. Chan School of Public Health, Boston, MA, USA)
Overview
Certain global genetic and epigenetic aberrations are disproportionally distributed across the colorectum, which corresponds to aetiological heterogeneity of colorectal cancer (CRC), especially hypermutated cancers, by anatomical location
With increasing incidence of CRC at younger ages, there is an urgent need to better identify high-risk individuals younger than 50 years, the age when screening typically starts
The constellation of factors associated with westernization, such as obesity, physical inactivity, poor diets, alcohol drinking and smoking, is likely to drive increasing CRC incidence in economically transitioning countries
Evidence indicates that aspirin probably confers chemopreventive benefit against CRC, though recommendation for its widespread prophylactic use is currently premature
Screening colonoscopy and faecal occult blood test, when implemented appropriately per national financial and medical resources and CRC incidence, could contribute to secondary prevention of CRC
The optimal reduction of CRC incidence and mortality will require concerted efforts to reduce modifiable risk factors, to leverage chemoprevention research and to promote population-wide and targeted screening
Cite
Keum, N., Giovannucci, E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol 16, 713–732 (2019). https://doi.org/10.1038/s41575-019-0189-8
TL;DR
Review provides a comprehensive summary of CRC epidemiology, with emphasis on modifiable lifestyle and nutritional factors, chemoprevention and screening. Overall, the optimal reduction of CRC incidence and mortality will require concerted efforts to reduce modifiable risk factors, to leverage chemoprevention research and to promote population-wide and targeted screening.
Link
https://www.nature.com/articles/s41575-019-0189-8#Abs1
Author/Institution
NaNa Keum (Harvard T.H. Chan School of Public Health, Boston, MA, USA)
Overview
Certain global genetic and epigenetic aberrations are disproportionally distributed across the colorectum, which corresponds to aetiological heterogeneity of colorectal cancer (CRC), especially hypermutated cancers, by anatomical location
With increasing incidence of CRC at younger ages, there is an urgent need to better identify high-risk individuals younger than 50 years, the age when screening typically starts
The constellation of factors associated with westernization, such as obesity, physical inactivity, poor diets, alcohol drinking and smoking, is likely to drive increasing CRC incidence in economically transitioning countries
Evidence indicates that aspirin probably confers chemopreventive benefit against CRC, though recommendation for its widespread prophylactic use is currently premature
Screening colonoscopy and faecal occult blood test, when implemented appropriately per national financial and medical resources and CRC incidence, could contribute to secondary prevention of CRC
The optimal reduction of CRC incidence and mortality will require concerted efforts to reduce modifiable risk factors, to leverage chemoprevention research and to promote population-wide and targeted screening
Cite
Keum, N., Giovannucci, E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol 16, 713–732 (2019). https://doi.org/10.1038/s41575-019-0189-8
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