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Abstract
Colorectal cancer (CRC) is the second most common lethal cancer in the Western world. There is a 10 to 20 years lead time from normal mucosa to carcinoma which offers a window of opportunity to modify and prevent the outcome of CRC, with its incipient morbidity and mortality. The objective of this paper is to review the evidence for chemoprophylaxis in CRC, identify currently used agents and determine their role in the current management algorithm of CRC. Large cohort-control and randomised controlled trials in the most studied chemoprophylaxis agents are reviewed. Currently, the role for chemoprophylaxis in CRC remains a niche area, with celecoxib the only recommended agent for use in patients with familial polyposis syndromes. However, the role of chemoprophylaxis is likely to grow significantly in the next decade as understanding of the stepwise tumorigenesis cascade becomes better understood and current clinical trials are completed.
Acknowledgements
This paper is published as part of a supplement forming the Proceedings of the 5th Annual Conference of the Organisation for Oncology and Translational Research (OOTR). Publication 495 of this supplement is supported by an educational grant from GlaxoSmithKline Ltd. The 5th Annual Conference of OOTR was supported by the following sponsors: GlaxoSmithKline; Pfizer; Novartis; Sanofi-aventis; Roche; AstraZeneca; Genomic Health; Wyeth; Orient Europharma; 500 Medicom; Tin Hang Technology; MacKay Medical Group; Macau Tourism Board.