Prevention and screening for colorectal cancer

Colorectal cancer is one of the most common cancers worldwide. It is related to adoption of the western way of life and in the majority of cases, excluding the hereditary type, it appears to be more common in elderly people. This means that by using suitable prevention strategies, either primary, by changing lifestyle, or secondary through screening methods, reduction in incidence and mortality can be achieved. Risk factors which are responsible for colorectal cancer and are the main target of primary prevention, are the low consumption of fruits and vegetables, the increased consumption of fat and alcohol, smoking, and reduced physical activity. There are also reports of chemoprevention with non-steroidal anti-inflammatory agents. With regards to secondary prevention, it is strongly recommended that screening should start at the age of 50 years, for people with average risk for colorectal cancer and earlier for those with advanced risk, such as people with a family history of colorectal cancer or familial forms of cancer, according to the specific guidelines of international societies concerning the appropriate screening methods and frequency of control. The gold standard of this screening is colonoscopy, which reveals a significant number of patients with precursor lesions for colorectal cancer, leading to the reduction of a great number of deaths from this cancer.