Alaa Rostom is a gastroenterologist, clinical epidemiologist and Associate Professor of medicine and community health sciences at the University of Calgary (Calgary, Alberta). He has an interest in the effects of acetylsalicylic acid (ASA), nonsteroidal antiinflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors on the gastrointestinal (GI) tract, and has conducted several meta-analyses on the prevention of NSAID-related GI toxicity. He also recently led an extensive systematic review for die US Preventive Services Task Force on the use of ASA, NSAIDs and COX-2 inhibitors for the chemoprevention of colon cancer (1,2). PA: Can you define chemoprevention of colorectal carcinoma (CRC)? AR: Chemoprevention refers to the use of an intervention (drug, dietary supplement, etc) on a regular basis by an individual to prevent or reduce the risk of the development of colorectal cancer. Primary chemoprevention refers to the use of such an intervention in subjects without a history of colon cancer. Secondary chemoprevention refers to the use of the intervention in subjects with a history of a resected colorectal cancer. The population in which the intervention is used is also commonly defined in terms of risk. Average-risk individuals are those who have no risk factors for CRC other than age (older than 50 years). Higher risk individuals are those with a family history of spo~ radic CRC or a personal history of polyps. High-risk individuals are those with a personal history of CRC, or a personal or family history of polyposis or nonpolyposis familial colon cancer syndromes (eg, familial adenomatous polyposis [FAP] and hereditary non-polyposis colon cancer [HNPCC]).
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