How to Reduce the Threat of Colorectal Cancer? From the Viewpoints of Lifestyle-related Diseases to Preventive Medicine

Abstract

  Colorectal cancer (CRC) is an important public health problem. Both hereditary and environmental factors interact to result in sequential occurrence from adenoma to adenocarcinoma. In terms of natural history of CRC development and progression, three strategies are available to improve its outcome. Identification of modifiable risk factors and adopting a healthy diet and lifestyle, named as primary prevention, can decrease the occurrence of CRC. For asymptomatic high-risk population, early detection by screening can greatly increase survival and even reduce the incidence, which is called secondary prevention. In symptomatic patients who are diagnosed as CRC at later stage, tertiary prevention through surgery, chemotherapy, target or immune therapy, aims to prolong survival and improve life quality. Although tertiary prevention is the current standard of clinical practice, the effects of primary and secondary prevention are obviously better than tertiary prevention from preventive medicine viewpoints. In the era of precision medicine, further challenges in CRC prevention and screening program should move beyond one size fits all and embrace more personalized program. My practice in Ningen Dock show integrated approaches to combine primary and secondary prevention is the best way to optimize the efforts for improving CRC prevention and survival.