Prevention of Colorectal Cancer: The Future Is Now

An estimated 140,000 new cases of colorectal cancer (CRC) were diagnosed in the USA in 2013. This review focuses on primary, secondary, and tertiary efforts to improve outcomes for patients at risk of CRC. Primary prevention to prevent the occurrence of CRC should focus on the reduction of modifiable CRC risk factors, including education regarding the deleterious effects ofWestern diets consisting of red and processed meats and the dangers of a sedentary lifestyle and obesity. Foods containing folates, vitamin D, and calcium may be protective against CRC and their consumption should likely be encouraged. Secondary preventive screening efforts can have a profound effect on reducing mortality by identifying neoplasia when precancerous lesions such as adenomas may be removed or when early-stage CRCs exist. Efforts must be made to increase the uptake of CRC screening on a worldwide level. The most resounding data for pharmacologic success in the prophylaxis of colorectal neoplasia belong to the class of aspirin and nonsteroidal antiinflammatory drugs. Future therapies improving the efficiency of CRC screening modalities and genomic medical breakthroughs to personalize prophylactic treatments will change the way CRC prevention is viewed.