Primary prevention of colon cancer with dietary and micronutrient interventions

Overall, colorectal carcinoma is the second leading cause of cancer death and the third most common carcinoma in both females and males in the United States. Adjusted incidence rates for whites are consistently higher than those for African Americans, whereas case-fatality rates are consistently lower for whites. Its etiology appears to be related to a complex interaction of environmental and genetic factors. Proposed dietary risk factors for colon carcinoma include excess fat intake and low intakes of fruits, vegetables, dietary fiber, calcium, and other micronutrients. Phase III clinical dietary and micronutrient trials are being conducted with the support of the National Cancer Institute for low fat-high fruits and vegetables, wheat bran fiber, calcium, folic acid, and selenium employing colonic adenoma recurrence as the primary outcome endpoint. If these studies are positive, then the implementation of dietary and/or micronutrient interventions could have an immense public health impact by reducing colon carcinoma mortality. Cancer 1998;83:1734-1739.