Role of diet and NSAIDs in the chemoprevention of colorectal cancer.

Colorectal cancer is a major public health problem. It is also one of the most preventable cancers. Although the colorectal cancer incidence and mortality in whites have been declining over the past 2 decades, these statistics are rising in nearly all ethnic minority groups. The development of colorectal cancer is influenced by exogenous factors, such as dietary constituents and drugs. While reputable data on the chemopreventive effects of diet and drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), in specific minority groups are limited, evidence suggests that dietary factors may affect colorectal carcinogenesis in various ethnic minority groups. Clearly, more studies are necessary to resolve these questions. Because the risk of colorectal cancer is increasing in minority patients, they cannot wait for the results of such studies. Therefore, until definitive data are available, it is prudent for physicians to recommend that all individuals be screened for colorectal cancer according to accepted guidelines and to educate them regarding healthful eating habits that will prevent the development of colorectal cancer. Physicians should be particularly vigilant in recommending these approaches to minority patients. Patients should be advised to consume a well-balanced, low-fat, high-fiber diet that is rich in fruits and vegetables.