息肉形成的化学预防
非甾体抗炎药 (NSAIDs) 减少息肉形成:有高质量证据表明阿司匹林或舒林酸(至少使用1年)可以降低新息肉形成的风险,相对风险降低至0.81(95%可信区间0.72至0.91)。[60]Kanik EA, Canbaz H, Colak T, et al. Chemopreventive effect of nonsteroidal anti-inflammatory drugs on the development of a new colorectal polyp or adenoma in a high-risk population: a meta-analysis. Curr Ther Res Clin E. 2004;65:345-352.系统评价或者受试者>200名的随机对照临床试验(RCT)。和钙补充剂新腺瘤的形成风险:有高质量证据表明补充钙剂至少3年可以降低新腺瘤形成的风险(OR 0.74,95% 可信区间为0.58至0.95)。[11]Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev. 2008;(1):CD003548.http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003548/frame.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/16034903?tool=bestpractice.com系统评价或者受试者>200名的随机对照临床试验(RCT)。被评估作为新息肉形成的化学预防药物。但是,目前尚没有足够的证据支持推荐常规使用钙补充剂预防结直肠癌,[11]Weingarten MA, Zalmanovici A, Yaphe J. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. Cochrane Database Syst Rev. 2008;(1):CD003548.http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD003548/frame.htmlhttp://www.ncbi.nlm.nih.gov/pubmed/16034903?tool=bestpractice.com由于潜在的心血管事件风险,非甾体抗炎药不作为此适应症的常规推荐。[12]Jin XF, Tong JL, Ran ZH. Selective cyclooxygenase-2 inhibitors for the prevention of colorectal adenomas: a meta-analysis. [Article in Chinese.] Chin Med J. 2007;87:1958-1961.http://www.ncbi.nlm.nih.gov/pubmed/17923032?tool=bestpractice.com[13]Dube C, Rostom A, Lewin G, et al. The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med. 2007;146:365-375.http://www.annals.org/content/146/5/365.longhttp://www.ncbi.nlm.nih.gov/pubmed/17339622?tool=bestpractice.com[16]Cooper K, Squires H, Carroll C, et al. Chemoprevention of colorectal cancer: systematic review and economic evaluation. Health Technol Assess. 2010;14:1-206.http://www.ncbi.nlm.nih.gov/pubmed/20594533?tool=bestpractice.com[15]Bertagnolli MME, Tang JR, Anderson F, et al. Celecoxib for the prevention of sporadic colorectal adenomas. N Engl J Med. 2006;355:873-884.http://www.ncbi.nlm.nih.gov/pubmed/16943400?tool=bestpractice.com[14]Arber N, Eagle CJ, Spicak J, et al. Celecoxib for the prevention of colorectal adenomatous polyps. N Engl J Med. 2006;355:885-895.http://www.ncbi.nlm.nih.gov/pubmed/16943401?tool=bestpractice.com
腹腔镜手术/经自然腔道内镜手术(NOTES)
一种联合内镜切除术和腹腔镜前哨淋巴结活检的方法正在评估中。