[Prevention of colon cancer--update 2008]

Today effective prevention of colorectal cancer can be done. For primary prevention there are good data for the recommendation of regular physical activity and body weight reduction if BMI is greater than 25 kg/m(2). Furthermore colorectal cancer risk correlates with alcohol intake and the harmful role of tobacco is well documented. But the influence of nutrition seems to be small. The results of a lot of studies are inconsistent. Diets high in fiber are recommended. The intake of red or processed meat seems to be associated with a higher risk for colorectal cancer. With the additive intake of vitamins and antioxidants the risk of colorectal cancer cannot be reduced. At present the use of drugs like aspirin, NSAD or statins cannot be recommended for primary prevention. The fecal occult blood test (FOBT) is the standard of the non-invasive screening methods. But regarding sensitivity and specificity there are better results for the new immunochemical fecal occult blood tests. The TuM2-PK test is an another screening method, but seems to be inferior to the immunochemical tests. Colonoscopy is the gold standard in the prevention of colorectal cancer. But it is important to improve the acceptance of this screening method in general population.