Frontiers in carcinoma of the colorectum from carcinogenesis to adjuvant therapy.

Recognition of a variety of environmental factors at variance and correlating with colorectal cancer incidence brings hope that prevention by environmental manipulation can be achieved. Refinements in detection methodology continue to optimize the benefit-cost ratio in discovering minimal large bowel cancer. This is the most significant advance in improving end results of treatment for this number one cancer killer in the United States. Little progress has been made in improving surgical procedures, although the no-touch technique stands out as the single important contribution. Adjuvant radiation therapy, chemotherapy, immunotherapy, and chemoimmunotherapy have not improved results over surgery alone.