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Chemoprevention of colorectal cancer: why all the confusion?

机译:结直肠癌的化学预防:为什么所有的混乱?

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PURPOSE OF REVIEW: Chemoprevention provides an opportunity to complement screening for the prevention of colorectal neoplasia. Findings from prospective randomized trials often conflict with those of observational studies. This review discusses some of the possible reasons based on recent clinical trials. RECENT FINDINGS: A recent prospective randomized trial demonstrates that folic acid supplementation in patients with a previous history of colorectal adenomas does not reduce future colorectal adenoma risk, and may possibly increase the risk of colorectal neoplasia. SUMMARY: The results of prospective randomized human trials of chemopreventive agents have in many cases been less impressive or have conflicted with the results of observational studies. Issues to be considered are the timing of the intervention during multistep carcinogenesis, baseline levels in a given individual or population, the complexity of dietary interactions, dose-response effects, and the duration of study.
机译:审查目的:化学预防提供了有机会补充筛查预防结直肠瘤形成。 前瞻性随机试验的调查结果经常与观察性研究发生冲突。 本次审查讨论了基于最近的临床试验的一些可能的原因。 最近的发现:最近的前瞻性随机试验表明,患有先前结肠直肠腺瘤病史的叶酸补充剂不会降低未来的结肠直肠腺瘤风险,并且可能会增加结直肠瘤的风险。 概述:前瞻性随机化人类的化学预防性药物的结果在许多情况下,在许多情况下不太令人印象深刻或随着观察研究的结果而被冲突。 要考虑的问题是多学期致癌发生期间干预的时间,给定的个体或群体的基线水平,膳食相互作用,剂量 - 反应效应的复杂性和研究持续时间。

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