Chemoprävention und Ernährungsfaktoren bei Darmkrebs

Abstract

Despite a reduction in colorectal cancer rates in recent years, colorectal cancer is still one of the leading cancers in the Western world. Increasing evidence suggests that a Western diet, high in calories and mostly relying on meat and a reduction in fiber intake, increases the risk for colorectal cancer. More than 800 epidemiologic studies led to the decision by the World Health Organization (WHO) to categorize processed meat as cancerogenic. However, studies like the European Prospective Investigation into Cancer and Nutrition (EPIC) point out strategies to reduce colorectal cancer risk. Especially a well-balanced diet, fiber-rich and reduced in meat, together with a normal body mass index (BMI) and waist circumference is negatively associated with colorectal cancer risk. A fiber-rich diet also affects the intestinal microbiota and is associated with an increase in the metabolite butyrate. Most recent studies showed that other aspects of the Western diet may also influence intestinal homeostasis. Certain dietary supplements and food additives seem to have negative effects in susceptible mice, resulting in severe colitis on the short-term and an increased colorectal cancer risk on the long-term. Besides nutrition, colorectal cancer chemoprevention is an important factor for patients at high risk such as Lynch syndrome patients. Most data is available on long-term, low-dose acetylsalicylic acid reducing colorectal cancer risk. Within this review we would like to elucidate the influence of drugs, diet and nutritional factors on colorectal cancer risk.