Dietary Lifestyle and Colorectal Cancer Onset, Recurrence, and Survival: Myth or Reality?
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Dietary Lifestyle and Colorectal Cancer Onset, Recurrence, and Survival: Myth or Reality? Katia Lofano & Mariabeatrice Principi & Maria Principia Scavo & Maria Pricci & Enzo Ierardi & Alfredo Di Leo Published online: 10 August 2012 # Springer Science+Business Media, LLC 2012
Abstract Background and Purpose Interest in the possibility that diet might help to reduce the risk of colorectal cancer dates back to 1970 based on both the large variation in rates of specific cancers in different countries and the impressive changes observed in the incidence of cancer in migrants from low- to high-risk areas. Here, we report the state of art of literature data about this topic. Methods Three sections have been separately considered: chemoprevention of first tumor onset, chemoprevention of recurrence after surgery, and chemoprevention of polyp recurrence in the course of the follow-up of subjects with elevated risk. A particular attention has been pointed to dietary factors and survival, whose relevance is showing a growing interest. Results The relationship between diet and colorectal cancer has been extensively studied about the onset, sometimes with controversial results. Its influence on recurrence and survival has been examined in only few studies. Conclusions Literature data are convincing for a protective role on the onset of preneoplastic and neoplastic lesions for some foods such as fibers, vitamin A and D, folic acid, calcium, antioxidants, and promising perspectives for some substances such as phyto-estrogens. Less evidenceK. Lofano : M. Principi : M. P. Scavo : M. Pricci : A. Di Leo Department of Emergency and Organ Transplantation, Section of Gastroenterology, Bari, Italy E. Ierardi Department of Medical Sciences, Section of Gastroenterology, Foggia, Italy A. Di Leo (*) Gastroenterology Unit, Department of Emergency and Organ Transplantation (DETO), University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy e-mail: [email protected]
based data are available on the possibility to avoid the recurrence of the disease or to affect its mortality with dietary habits. Future perspectives will be directed be not only to identify new dietary style able to prevent the onset of neoplastic lesion of the colon but also to realize an effective chemoprevention. Keywords Diet . Colorectal cancer/adenoma . Chemoprevention . Recurrence . Survival
Introductive Remarks The role of diet in the etiology of various type of cancer [1] remains an area of active research. Interest in the possibility that diet might help to reduce the risk of various types of cancer—including colorectal cancer—dates back to 1970 basing on both the large variation in rates of specific cancers in different countries and the impressive changes observed in the incidence of cancer in migrants from low- to high-risk areas [2, 3]. The importance of lifestyle factors in the development of cancer was also shown in studies of monozygotic twins (who share all genes). Inherited genetic factors were shown to be responsible for about the 15 %
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