Advances in chemoprevention of familial adenomatous polyposis

Familial adenomatous polyposis (FAP) is an autosomal dominant hereditary disease characterized by the early onset of numerous intestinal polyps, which, if untreated, may progress to colon cancer. Traditional treatments have primarily relied on surgical resection; however, with advancements in molecular biology and pharmacology, chemoprevention has increasingly become an important adjunct in the treatment of FAP. This review systematically summarizes the molecular pathological mechanisms of FAP and recent advances in chemopreventive strategies, including nonsteroidal anti-inflammatory drugs (NSAIDs) and combination regimens, prostaglandin E₂ receptor antagonists, phytoestrogens, targeted pathway inhibitors, as well as emerging interventions including gut microbiota modulation and natural products.