Chemoprevention in colorectal neoplasias: what is practical and feasible?

Chemoprevention strategies for colorectal cancer have gained increasing attention. Despite contradictory data regarding the use of micronutrients and antioxidant vitamins as chemopreventive tools, the identification of cyclooxygenase 2 (COX-2) upregulation in colorectal adenomas has led to the development of new drugs, named COX-2 inhibitors, that directly target the molecular mechanism of carcinogenesis. Celecoxib, one of the two COX-2 inhibitors available on the market, has been approved for chemoprevention of familial adenomatous polyposis. In the future, we might expect these drugs to be used in the prevention of colon cancer in patients at increased risk, such as those with a positive family history.