El Cáncer en datos: ¿Se aplican las medidas de prevención para el Cáncer Colorrectal?

  • Pedro J. Tarraga López Departamento de Medicina. Universidad de Castilla-La Mancha
  • José A. Rodríguez Montes Catedrático Emérito de Cirugía Universidad Autónoma de Madrid
  • Juan Solera Albero Coordinador Médico EAP zona 7 Albacete
  • Almudena Tárraga Marcos Departamento de Medicina. Universidad de Castilla-La Mancha
Palabras clave: Cáncer, Cáncer Colorrectal, Prevención Primaria, Prevención Secundaria

Resumen

Introducción: El cáncer es un problema mundial ya que afectará a uno de cada tres hombres y una de cada cuatro mujeres durante su vida. El cáncer colorrectal (CCR) es el segundo cáncer más frecuente en los hombres, después del cáncer de pulmón, y es el segundo cáncer más frecuente en mujeres después del cáncer de mama. También es la segunda causa de muerte en hombres y mujeres por separado, y es la segunda causa más frecuente de muerte por cáncer si ambos géneros son considerados juntos. El CCR representa aproximadamente el 10% de las muertes por cáncer. Los factores de riesgo modificables del CCR incluyen el tabaquismo, la inactividad física, el sobrepeso y la obesidad, el consumo de carne procesada y el consumo excesivo de alcohol. Los programas de cribado del CCR son posibles en los países económicamente desarrollados; sin embargo, se debe prestar atención en el futuro a áreas geográficas con población envejecida y estilo de vida occidental.

Objetivo: Evaluar la influencia de la dieta y el estilo de vida sobre la incidencia y la mortalidad del CCR y determinar el efecto de la prevención secundaria mediante el diagnóstico temprano del CCR.

Metodología: Se realiza una búsqueda exhaustiva de los artículos Medline y Pubmed relacionados con la prevención primaria y secundaria del CCR y posteriormente se realiza un metanálisis de los mismos bloques.

Resultados: Se recuperaron 301 artículos relacionados con la prevención primaria o secundaria del CCR. De éstos 177 fueron considerados válidos en el metanálisis: 12 en epidemiología, 56 en dieta y forma de vida, y sobre 77 diversas proyecciones para la detección temprana del CCR. El cáncer es un problema mundial ya que afectará a uno de cada tres hombres y una de cada cuatro mujeres durante su vida. No hay duda de cuáles factores ambientales, probablemente la dieta, pueden explicar estas tasas de cáncer. El consumo excesivo de alcohol y la dieta rica en colesterol están asociados con un alto riesgo de cáncer de colon. Una dieta pobre en ácido fólico y vitamina B6 también se asocia con un mayor riesgo de desarrollar cáncer de colon con una sobreexpresión de p53. Comer pulsos al menos tres veces a la semana reduce el riesgo de desarrollar cáncer de colon en un 33%, después de comer menos 
carne, mientras que comer arroz integral al menos una vez a la semana reduce el riesgo de CCR en un 40%. Estas asociaciones sugieren un efecto dosis-respuesta. Frecuentemente comiendo verduras cocidas, nueces, frutos secos, legumbres y arroz integral se ha asociado con un menor riesgo de pólipos colorrectales. La ingesta alta de calcio ofrece un efecto protector contra los tumores distales del colon y del recto en comparación con el colon proximal. Una mayor ingesta de productos lácteos y calcio reduce el riesgo de cáncer de colon. Tomar regularmente una aspirina (ASA) después de ser diagnosticado de cáncer de colon se asocia con menos riesgo de morir por este cáncer, especialmente entre las personas que tienen tumores con sobreexpresión de COX-2.16 Sin embargo, estos datos no contradicen los obtenidos sobre una posible predisposición genética, incluso en CCR esporádico o no hereditario. El CCR es susceptible a la detección porque es un problema de salud grave debido a su alta incidencia y su alta morbilidad / mortalidad asociada.

Conclusiones: El cáncer es un problema mundial. (2) Una modificación de la dieta y estilo de vida podría reducir la morbilidad y la mortalidad. (3) La detección temprana mediante el cribado mejora el pronóstico y reduce la mortalidad.

 

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Publicado
2017-09-22