Colon and Rectal Cancers - Prevention

In some studies, combining NSAIDs with the cholesterol-lowering drugs known as statins (for example, lovastatin, pravastatin, simvastatin) significantly lowered the rate of colon cancer compared to taking NSAIDs alone. Experts are hoping that such combinations may allow lower NSAIDs dosages, thereby reducing the risk for side effects, but further study is required. Preliminary evidence presented at the 2004 American Society for Clinical Oncology (ASCO) conference indicated that statins themselves may help reduce the risk of colorectal cancer, but more research is needed.

text continues below

Complications. It is important to note that NSAIDs, even in low doses, can cause gastrointestinal bleeding and ulcers in some people. In fact, studies estimate NSAID-related deaths in the United States at 10,000 to 20,000 per year, and NSAID-related hospitalizations at 100,000 per year. COX-2 inhibitors may have fewer of these side effects, although long-term studies are still needed.

Exercise

Studies have indicated that regular, even moderate exercise (30-minute daily jog or 60-minute daily walk) reduces the risk of colon cancer. Regular activity may be the most important lifestyle component in decreasing colon cancer risk. In one 2002 study, women who performed strength training exercises twice a week reduced several markers for both breast and colon cancer. The ultimate impact of these changes on breast and colon caner remains to be determined.

Estrogen in Women

Estrogen has been associated with a lower risk for colon cancer, perhaps because of specific enzymes the prevent cell proliferation. Agents containing estrogen, then, may help high-risk women:

There is some evidence that hormone replacement therapy (HRT) reduces the risk of colon cancer in postmenopausal women. It carries other risks, however, including a higher risk for breast and uterine cancer and blood clots. A 2004 study published in the New England Journal of Medicine found that while short-term use of estrogen plus progestin reduced the risk of developing colon cancer, combination HRT users who were diagnosed with the disease had more advanced forms of the cancer. Older women who are at higher risk for colon cancer might discuss risks and benefits of HRT with their physician.
Oral contraceptives may reduce younger women's risk of colon cancer. Duration of use does not seem to be associated with decreased risk, but protection appears stronger for women who have used oral contraceptives more recently.

5-ASAs

Medications containing 5-aminosalicylate (5-ASA)are sometimes given to patients with ulcerative colitis to help control inflammation. These drugs, which include sulfasalazine and mesalamine, are chemically related to aspirin. A 2005 review of clinical trials found that patients with ulcerative colitis who used 5-ASA were 49% less likely to develop colorectal cancer than patients who did not use these drugs