Marshall James R
Roswell Park Cancer Institute, Elm and Carlton, Buffalo, NY 14263, USA.
Gastroenterol Clin North Am. 2008 Mar;37(1):73-82, vi. doi: 10.1016/j.gtc.2007.12.008.
This article focuses on preventing the initiation and promotion of neoplastic growth in colon cancer, particularly with dietary measures. A goal of dietary epidemiology is to identify chemopreventive agents and strategies. The effects of diet are analyzed by observational approaches and experimental dietary, nutritional, or chemopreventive interventions. Short-term trials that alter intermediate biomarkers that are more sensitive than the adenoma to interventions may be necessary. The same logic needs to be applied to chemoprevention. Nonsteroidal anti-inflammatory drugs, calcium, and selenium have some individual effects that could be potentiated if added together. The current evidence is that the combined effect of all three agents is modest, compared with the effects of screening, or even those of smoking cessation.
本文着重于预防结肠癌中肿瘤生长的起始和促进，尤其是通过饮食措施。饮食流行病学的一个目标是识别化学预防剂和策略。通过观察性方法以及实验性饮食、营养或化学预防干预措施来分析饮食的影响。可能需要进行短期试验，这些试验要改变比腺瘤对干预更敏感的中间生物标志物。同样的逻辑也需要应用于化学预防。非甾体抗炎药、钙和硒有一些个体效应，如果将它们联合使用，这些效应可能会增强。目前的证据表明，与筛查的效果相比，甚至与戒烟的效果相比，这三种药物的联合效果是适度的。
