Beyond screening; emerging strategies for primary prevention of colorectal cancer

Abstract

Emerging strategies for colorectal cancer (CRC) primary prevention are rapidly evolving, emphasizing modifiable lifestyle factors, precise risk assessment, and targeted early interventions. A substantial body of evidence highlights the critical role of maintaining a healthy weight, regular physical activity, and dietary modifications, including limiting red and processed meats, along with avoiding tobacco and moderating alcohol consumption. Innovations in microbiome research are uncovering how gut dysbiosis influences carcinogenesis, paving the way for potential probiotic and prebiotic interventions to restore gut health. Advances in genetic and molecular profiling now facilitate personalized risk stratification, enabling tailored preventive approaches for high-risk populaces, like cases with hereditary syndromes or elevated polygenic risk scores. Chemoprevention, particularly with aspirin and other nonsteroidal anti-inflammatory drugs, shows promise for at-risk individuals, though careful consideration of benefits versus potential harms, such as gastrointestinal bleeding, is essential. Public health initiatives promoting fiber-rich diets, whole grains, and adequate calcium intake are gaining momentum as safe and scalable preventative measures. The integration of digital health tools and AI-driven models is further enhancing early identification of at-risk individuals and improving adherence to preventive behaviors. By deepening our understanding of CRC pathogenesis and combining these multifaceted strategies into routine clinical care and community health programs, there is a significant opportunity to substantially reduce the global burden of CRC. Continued research, robust policy support, and equitable access to preventive resources are crucial for achieving this transformative potential.

Keywords: Colorectal neoplasms, Preventive health services, Dietary supplements, Lifestyle