Materiały źródłowe

• #1 Preventing bowel cancer | How you can reduce the risk

  https://www.wcrf.org/preventing-cancer/cancer-types/bowel-cancer/preventing-bowel-cancer/

  Bowel cancer is one of the most common cancers in the UK and worldwide, but it is also one of the most preventable. Making changes to your diet and lifestyle can significantly reduce your risk. […] Around 45% of bowel cancer cases could be prevented by following our Cancer Prevention Recommendations. Here are 6 ways to reduce your bowel cancer risk, based on research from our Global Cancer Update Programme. […] Eating a fibre-rich diet, including wholegrains, can reduce bowel cancer risk. […] Eating processed meat, such as ham, bacon and sausages, and too much red meat, including beef, pork and lamb, increases bowel cancer risk. […] Regular physical activity helps reduce bowel cancer risk by helping you maintain a healthy weight and supporting digestion. […] Maintaining a healthy weight can reduce your risk of 13 different types of cancer, including bowel cancer.

• #1 Prevention Tips – The Mount Sinai Hospital | Mount Sinai – New York

  https://www.mountsinai.org/care/cancer/services/colon/prevention-tips

  Colon and rectal cancers (colorectal) are among the most common cancers in both men and women in the United States. They are also some of the most preventable – and treatable – of all cancers. […] During routine screening for colon and rectal cancer, physicians can find polyps (growths or lesions inside the large intestine) and remove them before they become cancerous. (Colon and rectal cancer arises from colon and rectal polyps.) A routine screening can also find colon and rectal cancer at its earliest stages when it can be more easily and successfully treated. […] Most people should start being screened for colon and rectal cancer at age 45. Your doctor may recommend you undergo screening at an earlier age and be screened more frequently if you or a first-degree relative who has had colorectal cancer or adenomatous colon polyps (benign polyps), if you have a long history of inflammatory bowel disease (IBD), or other known risk factors.

• #1 Colorectal Cancer Prevention and Screening | UCSF Health

  https://www.ucsfhealth.org/education/colorectal-cancer-prevention-and-screening

  Maintain a healthy weight. Being obese or overweight increases your chances of developing colorectal cancer. […] Don’t smoke. Smoking cigarettes is linked with a higher risk of colorectal and other types of cancer. […] Avoid alcohol. Not drinking at all may reduce your risk. If you do drink, women should limit consumption to no more than one drink a day, and men to two drinks a day. […] Take a low dose of aspirin daily. Aspirin can reduce the development of polyps, particularly in patients with a previous history of polyps or colorectal cancer. […] Screening is for patients who show no symptoms of cancer. It is a preventive measure that anyone can take to catch abnormal cells early on. […] Polyps usually take about 10 to 15 years to develop into colorectal cancer. If theyre detected early, they can be removed before they turn into cancerous cells. Regular screenings also help to catch cancer cells in their early stages, when treatment is more effective.

• #1 Colon and Rectal Cancer: Prevention and Treatment | Stony Brook Medicine

  https://www.stonybrookmedicine.edu/patientcare/askexpert/colon-and-rectal-cancer

  Colorectal cancer arises from the lining of the colon or rectum, usually from cells that secrete mucus. In many cases, it starts out as a polyp, which is a premalignant, benign lesion or an overgrowth in the lining of the colon. If left alone, a polyp can grow into cancer. However, with screening, polyps can be detected and removed, thus preventing cancer. […] The ACS recommends that people undergo screenings starting at age 50 preferably via colonoscopy, which is considered the gold standard test with a follow-up every 10 years if no polyps are detected. Individuals at high risk should start screenings earlier and have more frequent follow-ups. […] Stony Brook Medicine is also working to advance the practice of medicine through clinical trials and research. It currently is participating in a multi-institution trial run by the American College of Surgeons Oncology Group to pioneer a minimally invasive laparoscopic treatment for rectal cancers.

• #1 Colorectal Cancer Prevention (PDQ®): Prevention – Patient Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.colorectal-cancer-prevention-pdq%C2%AE-prevention-patient-information-nci.ncicdr0000258007

  Obesity. Obesity is linked to an increased risk of colorectal cancer and death from colorectal cancer. […] The following protective factors decrease the risk of colorectal cancer: Physical activity. A lifestyle that includes regular physical activity is linked to a decreased risk of colorectal cancer. […] Aspirin. Studies have shown that taking aspirin daily for at least two years lowers the risk of colorectal cancer and the risk of death from colorectal cancer. The decrease in risk begins 10 to 20 years after patients start taking aspirin. […] Polyp removal. Most colorectal polyps are adenomas, which may develop into cancer. Removing colorectal polyps that are larger than 1 centimeter (pea-sized) may lower the risk of colorectal cancer. It is not known if removing smaller polyps lowers the risk of colorectal cancer. […] New ways to prevent colorectal cancer are being studied in clinical trials.

• #1 Colorectal Cancer Screening and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0515/p658.html

  Colorectal cancer is a common cause of morbidity and mortality in the United States. […] The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of age. […] There is good evidence that aspirin, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, and hormone therapy decrease the risk of colorectal cancer and adenomatous polyps, but potential harms limit their usefulness. […] There is good evidence that calcium supplementation, moderate dairy consumption, reduced red meat consumption, increased physical activity, decreased body mass index, and statin use decrease the risk of colorectal cancer and adenomatous polyps. […] Although increased alcohol intake and tobacco use are associated with an increased risk of colorectal cancer, there is no direct evidence that reducing alcohol consumption or smoking cessation decreases the risk.

• #1 Colorectal Cancer Prevention, Screening, Treatment, and Survivorship Recommendations | Oncology Nursing Society

  https://www.ons.org/news-and-views/colorectal-cancer-prevention-screening-treatment-and-survivorship-recommendations

  The American Cancer Society recommended that those at average risk begin CRC screening at age 45 with visual examination of the colon or stool-based tests (i.e., annual fecal occult blood testing, annual fecal immunochemical test, or multitargeted stool DNA test every three years). […] The most effective ways to lower CRC risk are through screening, diet, and lifestyle changes. Because most polyps take 10-15 years to develop into cancer, finding and removing polyps with screening can stop CRC before it starts. Researchers are also looking at use of aspirin for CRC prevention.

• #1 Screening and Prevention for People with a Family History of Colorectal Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/health-library/screening-prevention-for-people-with-a-family-history-of-colorectal-cancer

  In people with either one first-degree or two second-degree relatives (for instance, an aunt, uncle or grandparent) with colon cancer or pre-cancerous polyps, the above screening is recommended beginning at age 40 instead of 50, with a colonoscopy as the preferred method. A colonoscopy should be repeated at least every five years if the results are negative. […] Colonoscopy screening should begin at 40 years or 10 years earlier than the earliest case of colon cancer in the family. A colonoscopy should be repeated at least every five years if the results are negative. […] When a hereditary colorectal cancer syndrome is suspected or present in a family, members may begin screening at much younger ages and more frequently. In some cases, screening may begin in childhood or early adulthood and will often involve annual colonoscopy. […] People with a family history of colorectal cancer in several close relatives and across generations, especially if these cancers occur at a young age, may benefit from genetic counseling and genetic testing for the inherited syndromes of colon cancer.

• #1 Prevention Tips – The Mount Sinai Hospital | Mount Sinai – New York

  https://www.mountsinai.org/care/cancer/services/colon/prevention-tips

  While screening is the most effective way to prevent colon and rectal cancer, studies show that there are lifestyle-related steps that might decrease your chances of developing colon and rectal cancer: […] Eating plenty of fruits, vegetables, and whole grain foods (and limiting the amount of red and processed meat in your diet) is one of the best things you can do to lower your risk of colon and rectal cancer. […] Physical inactivity increases your risk of developing colon and rectal cancer. The American Cancer Society recommends at least 150 minutes of moderate intensity activity (such as brisk walking), or 75 minutes of vigorous intensity activity (activity that results in a faster heart rate, deeper breathing, and sweating), each week. […] Being overweight is linked to a variety of cancers, not just colon and rectal cancers.

• #1 Reducing colorectal cancer risk – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/reducing-your-risk-for-colon-cancer

  Colorectal cancer is cancer of the large intestine (colon) or the rectum. Following your health care team’s recommended screening schedule is the best way to reduce your risk of developing colorectal cancer. This may include a colonoscopy or other screening methods, beginning at age 45. […] Talk to your health care team about your colorectal cancer screening options. Learn what to expect before, during and after a colonoscopy. […] You can help reduce your risk of colorectal cancer if you: […] Eat your veggies and healthy fats. Research has shown that the Western diet correlates to higher colorectal cancer rates. People who eat high-fiber diets are less likely to develop the disease. Fruits, vegetables and whole grains contain vitamins, minerals, fiber and antioxidants, which may play a role in cancer prevention. Choose a variety of fruits and vegetables to get an array of vitamins and nutrients.

• #1 Primary Prevention of Colorectal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2947820/

  Limiting intake of processed meat and red meat, especially after high-temperature cooking, and replacing these foods with poultry or fish as alternative protein sources could be a reasonable approach to reducing risk of colorectal cancer. […] Calcium supplementation is likely to be at least modestly beneficial. […] Data support a significant, yet modest ability of calcium intake to prevent colorectal cancer. […] The precise mechanism by which vitamin D prevents colorectal cancer is not clear, but future randomized control trials of higher doses of vitamin D might provide more information. […] Although an association between colorectal cancer and vitamin D has not been definitively proven, it is important to achieve a level of at least 30 ng/mL, since this dose has been shown to be optimal for other health conditions.

• #1 Colorectal Cancer Prevention | How to Prevent Colorectal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/causes-risks-prevention/prevention.html

  Not drinking alcohol may help reduce your risk. […] Quitting smoking may help lower you risk of colorectal cancer and many other types of cancer, too. […] Some studies suggest that taking a daily multivitamin containing folic acid may lower colorectal cancer risk, but not all studies have found this. […] More research is needed to determine if increasing vitamin D intake from a supplement can help prevent colorectal cancer. […] Calcium and vitamin D might work together to reduce colorectal cancer risk. […] Many studies have found that people who regularly take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) have a lower risk of colorectal cancer and polyps. […] For some people in their 50s who have a high risk of heart disease, the aspirin may also have the added benefit of reducing the risk of colorectal cancer. […] Some studies have shown that taking estrogen and progesterone after menopause may reduce a womans risk of developing colorectal cancer, but other studies have not.

• #1 Colorectal Cancer Care and Prevention – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/colorectal-cancer-care-and-prevention.asp

  Obesity is defined as a BMI of 30 or greater, and is a risk factor for many solid tumors and chronic diseases. Studies show that both general and central obesity are associated with an increased risk of colorectal cancer, with a stronger association in men. […] Lifestyle modifications are imperative to prevent colorectal cancer. The top modifiable risk factors include exercising 30 minutes most days of the week and adapting a high-fiber diet with five to nine servings of fruits and vegetables per day. Adding garlic, soy, and omega-3 fats to the diet while reducing red meat, processed meat, and simple carbohydrates can have added benefit in the prevention of colorectal cancer. For average-risk patients, screening should start at age 45 with colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal occult blood testing for early detection of precancerous lesions. An anti-inflammatory diet with regular exercise is beneficial for colorectal cancer prevention.

• #1 Reducing your risk for colorectal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/colorectal/risks/reducing-your-risk

  You may lower your risk of developing colorectal cancer by doing the following. […] Research shows that regular physical activity can lower your risk for colorectal cancer. […] Research also shows that sedentary time, or sitting time, increases your risk for colorectal cancer. […] Research shows that being overweight or obese increases your risk for colorectal cancer. […] Drinking alcohol increases your risk of developing colorectal cancer. […] Smoking tobacco increases the risk of precancerous conditions and cancer of the colon or rectum. […] Diets that are high in red meat or include processed meats increase the risk for colorectal cancer. […] Research shows that eating foods containing dietary fibre lowers the risk of colorectal cancer. […] Research shows that eating dairy products lowers the risk for colorectal cancer.

• #1 Prevention | Colorectal Cancer Alliance

  https://colorectalcancer.org/screening-prevention/prevention

  Increasing your physical activity can reduce your risk of developing colorectal cancer by 30 to 40 percent. […] 30 to 60 minutes of moderate to vigorous physical activity per day is needed to protect against colorectal cancer. […] Exercise also helps you to maintain a healthy body weight, which reduces your risk for colorectal cancer. […] A family history of colorectal cancer puts you at an increased risk for the disease. […] If you have a family history, you may need to be screened at age 40, or 10 years before the youngest case in your immediate family, whichever is earlier. […] Prevent colorectal cancer with lifestyle changes.

• #1 Reducing colorectal cancer risk – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/reducing-your-risk-for-colon-cancer

  Get moving. You know exercise benefits your heart and can help you maintain your weight. It also may lower your risk of developing some types of cancer, including colorectal cancer. Aim for 30 minutes of moderate exercise on most days of the week. […] Watch your weight. Carrying extra pounds increases your risk of colorectal cancer, and cancers of the breast (in postmenopausal women), rectum, esophagus, pancreas and kidney, among others, according to the American Cancer Society. Talk to your health care team if you need help losing weight. […] Limit alcohol and don’t smoke. If you choose to drink alcohol, do so moderately. That means no more than one drink a day for women or two drinks a day for men. And if you smoke, quit. Your provider can offer tips or refer you to a program to help you stop.

• #1 6 Expert Tips to Prevent Colorectal Cancer

  https://www.cedars-sinai.org/newsroom/6-expert-tips-to-prevent-colorectal-cancer/

  Being overweight or obese increases the risk of getting colon or rectal cancer because it can alter the function of hormones, such as insulin and leptin, Chiu said. […] 5. Limit alcohol […] Alcohol can cause intestinal damage. It is a toxin whose byproduct can damage DNA, Chiu said. […] 6. Do not smoke […] Smoking increases the risk for colorectal cancer, Chiu said, because it causes DNA damage and inflammation in the intestine and lung.

• #1 Colon Cancer Prevention: 6 Tips for Reducing Your Risk

  https://www.healthline.com/health/colorectal-cancer/colon-cancer-prevention

  According to the National Cancer Institute, people with overweight or obesity are about 30 percent more likely to develop colon cancer than those without the conditions. […] Regular exercise can help you manage your weight and reduce your risk of colon cancer. […] Due to the nature of colon cancer, screening tests are done before signs and symptoms may develop. […] Colorectal cancer screening via traditional colonoscopy is typically recommended every 10 years starting at age 45. However, your doctor may recommend testing sooner and more often if you’re at higher risk. […] In the United States, about 13 percent of colon cancers are attributed to alcohol consumption, and 12 percent to current or former tobacco use. […] Current smokers are at a 50 percent higher risk of developing colon cancer than those who never smoked. […] Men with obesity have about a 50 percent higher risk of colon cancer than people without obesity, while women with obesity have about a 10 percent increased risk.

• #1 Prevention Tips – The Mount Sinai Hospital | Mount Sinai – New York

  https://www.mountsinai.org/care/cancer/services/colon/prevention-tips

  The link between smoking and lung cancer is well-known. But lesser known is that fact that smoking can also cause cancers of the digestive system, such as colon and rectal cancer. […] Heavy drinking is associated with numerous health problems, including colon and rectal cancer. […] There is evidence that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS), such as naproxen (Aleve®) and ibuprofen (Motrin®, Advil®) may decrease the risk of death from colon and rectal cancers. However, because aspirin can have side effects like bleeding from the bowels, you should consult your doctor before thinking of using aspirin or another NSAID for colon and rectal cancer prevention.

• #1 Colon Cancer Prevention: 6 Tips for Reducing Your Risk

  https://www.healthline.com/health/colorectal-cancer/colon-cancer-prevention

  Preventive measures can go a long way in reducing your risk of colorectal cancers, which are the third leading cause of death from cancer in the United States. […] While you cant prevent certain risk factors such as age and family history, early screening and lifestyle measures that address diet, exercise, and weight can help reduce your risk of colon cancer. […] Eating less red meat and processed meats, such as steak, ground beef, lunch meats, and hot dogs can significantly reduce your risk of colon cancer. […] Reducing or avoiding alcohol consumption can lower your risk of colon cancer. […] Smokers are at a 50 percent higher risk of developing colon cancer than those who never smoked. This means that if you smoke, one way to reduce your risk of colon cancer is to try to quit. […] Managing your weight is another way to reduce your risk of colon cancer.

• #1 Colorectal Cancer Prevention: How to Lower Your Risk and Stay Healthy

  https://www.cbwchc.org/news/colorectal-cancer-prevention

  Colorectal cancer risk can also be reduced through lifestyle changes. Research shows that by taking actions early and making simple, mindful changes to your daily habits, you can significantly reduce the chances of developing the cancer or prevent colorectal cancer from occurring altogether. […] Reducing or eliminating alcohol consumption and tobacco use are also important steps in lowering your risks. […] Quitting smoking can even reduce your risk of colorectal cancer by 40%, which is why it is one of the most effective actions you can take to protect you and your family’s health. […] Screening tests allow doctors to find colorectal cancer or precancerous polyps before symptoms appear. By detecting it early, treatment can begin before the polyp has a chance to develop into cancer, or if there is already cancer, prevent it from spreading. This strategy improves the chances of successful treatment and reduces the need for more aggressive care plans.

• #1 Aspirin for the prevention of colorectal cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3354696/

  Over 600,000 people worldwide die of colorectal cancer (CRC) annually, highlighting the importance of developing effective prevention strategies. Among proposed chemopreventive interventions, aspirin is perhaps the agent with the strongest body of evidence that supports wider spread use to significantly reduce the population burden of CRC. Several epidemiological studies, four randomized controlled trials (RCTs) of colorectal polyp recurrence, and RCTs in patients with hereditary colorectal cancer syndromes, have shown that aspirin reduces incidence of colorectal neoplasia. […] Recently, in a pooled analysis of five cardiovascular-prevention RCTs linked to cancer outcomes, daily aspirin use at any dose reduced the risk of CRC by 24% and of CRC-associated mortality by 35% after a delay of 810 years.

• #1

  https://www.facingourrisk.org/info/risk-management-and-treatment/screening-and-risk-reduction/by-cancer-type/colorectal/medications-to-reduce-risk

  In people with Lynch syndrome, daily aspirin may decrease the risk for colon cancer and other cancers. In one study, people who took 600 mg of aspirin daily for two years or more had a 60 percent decrease in their risk for colorectal cancer. […] More studies are needed to help experts understand the best dose and duration of aspirin to protect people with Lynch syndrome from colorectal cancer. […] In people with the rare syndrome Familial Adenomatous Polyposis (FAP), caused by an inherited mutation in the APC gene, the drugs Sulindac and celexicob have been shown to lower the risk for polyps. […] Vaccines are being studied in clinical trials to see if they can lower the risk for colorectal cancer in people with Lynch syndrome. […] Currently, there is not enough evidence to support using of any of these other agents to lower the risk for colorectal cancer.

• #1 Aspirin for the prevention of colorectal cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3354696/

  The other major known distinct genetic syndrome that underlies familial CRC is the Lynch syndrome, an autosomal dominantly inherited condition in which germline mutations in mismatch repair genes confer a high lifetime risk of cancers of the colorectum as well as other organs. […] The CAPP2 RCT was the first aspirin study to have CRC prevention as a primary end point. […] Aspirin had a lower CRC risk (incidence-rate ratio = 0.56; 95% CI, 0.320.99; P = 0.05) in ITT analyses accounting for multiple primary CRCs in some individuals. […] Taking clinical trial and observational data together, there is clear evidence that aspirin in doses as low as 325 mg per day reduces CRC risk. […] There is also strong evidence from secondary analyses of cardiovascular trials that daily doses as low as 75 mg per day may be effective. […] For individuals at high risk of CRC, such as those with Lynch syndrome, the results of the CAPP2 trial suggest a clearer case for aspirin use.

• #1 Colorectal cancer prevention: A proven benefit of nonsteroidal anti-inflammatory drugs – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/colorectal-cancer-prevention-a-proven-benefit-of-nonsteroidal-anti-inflammatory-drugs/

  Dr. Murad and his colleagues showed that nonaspirin NSAIDs are better than all the other compared therapies for preventing recurrence of adenomatous polyps within three to five years following initial polyp removal. However, because of some of the other health risks of nonaspirin NSAIDs, they may not be the best choice for everyone. […] Aspirin had nearly as good results, with much less additional risk. Dr. Murad and his colleagues cautioned that, although low-dose aspirin was ranked second in preventive capabilities, “the excess benefit over risk might therefore be favorable for many patients.” […] “It is important that patients and doctors have a discussion on the various risks and benefits of any medication or other therapy,” says Dr. Murad. “While a research publication may contain promising findings, it is generalized information, and each individual is different. So their care will be individualized, as well.”

• #1 Colorectal cancer prevention: A proven benefit of nonsteroidal anti-inflammatory drugs – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/colorectal-cancer-prevention-a-proven-benefit-of-nonsteroidal-anti-inflammatory-drugs/

  ROCHESTER, Minn. — Mayo Clinic researchers and a team of collaborating scientists from across the country have determined the comparative effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin and several supplements in preventing the recurrence of advanced neoplasia (polyps that are the precursor of colorectal cancer) after polyp removal. […] In their study, published this month in The BMJ, the research team showed that, for most patients, nonaspirin NSAIDs (e.g., ibuprofen) work better than aspirin or a host of nutritional supplements to prevent the growth of advanced adenomas. In the paper, they say that due to most colorectal cancers developing from this type of polyps, preventing them is a good proxy for colorectal cancer prevention. […] “Approximately 85 percent of all colorectal cancers are thought to result from untreated adenomatous polyps,” says M. Hassan Murad, M.D., a clinical epidemiologist and preventive medicine physician at Mayo Clinic, and the study’s senior author. “If we can find a way to stop their growth, we could prevent a majority of these cases.”

• #1 Colorectal Cancer Screening and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0515/p658.html

  The U.S. Preventive Services Task Force (USPSTF) recommends CRC screening for average-risk adults 50 to 75 years of age. […] The decision to screen adults 76 to 85 years of age should be individualized based on overall health, previous screening, willingness to undergo treatment for CRC if found, and comorbid conditions. […] Although aspirin use decreases CRC incidence by 40%, a 2016 USPSTF guideline including three RCTs recommended against aspirin use in the average-risk population because of the risk of gastrointestinal bleeding and hemorrhagic stroke. […] Studies show that nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors decrease the risk of CRC and adenomatous polyps; however, an increased risk of adverse effects outweighs potential benefits for most patients.

• #1 Colorectal Cancer | Cancer Screening and Prevention | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/chronic/cancer/colorectal-cancer.php

  Cigarette smoking is linked to an increased risk of developing colorectal cancer and death from the disease. […] Studies have shown that taking aspirin lowers the risk of colorectal cancer and the risk of death from colorectal cancer. […] Studies have shown that combination hormone replacement therapy (HRT) that includes both estrogen and progestin lowers the risk of invasive colorectal cancer in postmenopausal women. […] A doctor may consider a patients family health history when deciding which colorectal cancer screening might be appropriate. […] In some cases, colorectal cancer is caused by an inherited genetic condition called Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer or HNPCC. […] It is important for those who have been diagnosed with Lynch syndrome to talk to a doctor about an increased chance of getting other cancers caused by Lynch syndrome.

• #1 Reducing your risk for colorectal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/colorectal/risks/reducing-your-risk

  If you follow the screening guidelines for colorectal cancer, the cancer can be found before you notice symptoms. […] Some drugs may help to protect you from developing colorectal cancer. […] Research shows that people who take NSAIDs have a lower risk of developing colorectal cancer. […] Women who take HRT may have a lower risk of developing colorectal cancer. […] If you are at higher than average risk, you may need to visit your doctor more often to check for colorectal cancer. […] Prophylactic colectomy is surgery to remove the whole colon before colorectal cancer is diagnosed.

• #1 Colorectal Cancer Risk Factors | Hereditary Colorectal Risk Factors | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/causes-risks-prevention/risk-factors.html

  Many lifestyle-related factors have been linked to colorectal cancer. In fact, more than half of all colorectal cancers are linked to risk factors that can be changed. […] Following a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and that limits or avoids red and processed meats and sugary drinks probably lowers risk. […] If you have a family history of adenomatous polyps or colorectal cancer, talk with your doctor about the possible need to start screening at a younger age. If you’ve had adenomatous polyps or colorectal cancer, its important to tell your close relatives so that they can pass along that information to their doctors and start screening at the right age. […] Since many of these syndromes are linked to colorectal cancer at a young age and other types of cancer, identifying families with these inherited syndromes is important. It lets doctors recommend specific steps such as screening and other preventive measures when the person is younger.

• #1

  https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer

  Regular screening for colorectal cancer (secondary prevention) is the best way to catch the disease early. […] Studies have shown that screening can reduce both the incidence and mortality of colorectal cancer through early detection and removal of precancerous growths. […] Stool-based tests are non-invasive screening methods used to detect the presence of colorectal cancer or precancerous polyps in the stool. […] Individuals with a family history of colorectal cancer or certain genetic conditions may benefit from genetic counselling and genetic testing to assess their risk and determine appropriate screening measures.

• #1 Primary Prevention of Colorectal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2947820/

  The cornerstones of colorectal cancer prevention are screening and detection of adenomatous polyps. However, improving our understanding of the modifiable risk factors might inform additional primary prevention strategies that can further reduce risk. […] For lifestyle factors, there is compelling evidence that avoidance of smoking and heavy alcohol use, prevention of weight gain, and the maintenance of a reasonable level of physical activity can each have a positive influence on risk of colorectal cancer. […] Taken together, modification of multiple diet and lifestyle factors is likely to have a substantial overall impact on risk of colorectal cancer.

• #1 Rectal Cancer – Prevention

  https://ruesch.georgetown.edu/rectalcancerprevention/

  Cancer prevention is action taken to lower the chance of getting cancer. […] Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following risk factors increase the risk of colorectal cancer: Age, Family history of colorectal cancer, Personal history, Inherited risk, Alcohol, Cigarette smoking, Race, Obesity. […] The following protective factors decrease the risk of colorectal cancer: Physical activity, Aspirin, Combination hormone replacement therapy, Polyp removal. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent colorectal cancer are being studied in clinical trials.

• #1

  https://www.thechristhospital.com/healthspirations/colorectal-cancer-prevention-and-treatment

  Colorectal cancer is one of the few cancers that are preventable through recommended screenings and lifestyle changes. […] By screening for colorectal cancer, you can identify it earlier when it’s more likely to be curable,” Dr. Puthota says. You may just save your life or that of someone you love.” […] You should have regular screening tests between ages 45 to 75. However, if you have a parent, sibling or child with colorectal cancer, you should undergo testing earlier. Typically, you’ll want to begin screening 10 years before the age your relative was when they were diagnosed. […] The Christ Hospital Health Network has a program called TNT (total neo-adjuvant treatment regimen) for rectal cancer. After diagnosis and staging, you receive chemotherapy and radiation first, before any surgery.

• #1

  https://www.thechristhospital.com/healthspirations/colorectal-cancer-prevention-and-treatment

  Up to 40 percent of patients have a complete tumor regression (the tumor shrinks or disappears) after chemotherapy and radiation,” Dr. Rafferty explains. This is what we call a complete clinical response or cCR.” […] Some patients that have a cCR and no evidence of a tumor may not need surgery. Your doctor may recommend watching and waiting. […] Lifestyle practices, such as maintaining a healthy diet and regular exercise, can help. Some doctors recommend taking vitamin D, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

• #2 Seven ways to reduce your risk of bowel cancer – UK Health Security Agency

  https://ukhsa.blog.gov.uk/2019/04/01/seven-ways-to-reduce-your-risk-of-bowel-cancer/

  Every 30 minutes someone dies from bowel cancer, making it the UKs second biggest cancer killer. However, this shouldnt be the case as its a treatable and curable disease, especially if diagnosed early. […] Research shows that around half (54%) of all bowel cancers could be prevented by making simple changes to your diet and lifestyle. […] There is evidence that eating red and processed meat can increase your risk of bowel cancer. […] Fibre is an important part of a healthy diet as it aids digestion, prevents constipation and helps to reduce your risk of bowel cancer. […] Being overweight or obese and carrying a lot of weight around your waist can increase your risk of bowel cancer. It is estimated that 11 out of 100 bowel cancers (11%) in the UK are linked to people not having a healthy body weight.

• #2 Colorectal Cancer – American College of Gastroenterology

  https://gi.org/topics/colorectal-cancer/

  Age 45 is now the age to start screening for colorectal cancer among all average risk adults according to 2021 guidelines from the American College of Gastroenterology. This is an important change from earlier guidelines that used to recommend starting at age 50 for most people and age 45 for African Americans only. Your gastroenterologist can diagnose colorectal cancers at an earlier stage, find colon polyps early so they can be safely removed, and help to prevent colorectal cancers. […] Physicians from the American College of Gastroenterology want you to know that screening Colonoscopy can find growths in the colon called polyps so they can be removed before they turn into Colorectal Cancer. […] ACG recommends colorectal cancer screening in average-risk individuals between age 45 and 75 years to reduce pre-cancerous growths called advanced adenomas, reduce colorectal cancer, and reduce death from colorectal cancer.

• #2 Prevention | Colorectal Cancer Alliance

  https://colorectalcancer.org/screening-prevention/prevention

  Increasing your physical activity can reduce your risk of developing colorectal cancer by 30 to 40 percent. […] 30 to 60 minutes of moderate to vigorous physical activity per day is needed to protect against colorectal cancer. […] Exercise also helps you to maintain a healthy body weight, which reduces your risk for colorectal cancer. […] A family history of colorectal cancer puts you at an increased risk for the disease. […] If you have a family history, you may need to be screened at age 40, or 10 years before the youngest case in your immediate family, whichever is earlier. […] Prevent colorectal cancer with lifestyle changes.

• #2 Primary Prevention of Colorectal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2947820/

  The cornerstones of colorectal cancer prevention are screening and detection of adenomatous polyps. However, improving our understanding of the modifiable risk factors might inform additional primary prevention strategies that can further reduce risk. […] For lifestyle factors, there is compelling evidence that avoidance of smoking and heavy alcohol use, prevention of weight gain, and the maintenance of a reasonable level of physical activity can each have a positive influence on risk of colorectal cancer. […] Taken together, modification of multiple diet and lifestyle factors is likely to have a substantial overall impact on risk of colorectal cancer.

• #2 Dietary Prevention of Colon Cancer | UPMC Physician Resources

  https://www.upmcphysicianresources.com/news/011922-dietary-prevention-colon-cancer

  Colon cancer is the second leading cause of cancer-related deaths worldwide. […] A low-fiber diet places environmental pressure on the colonic epithelium, as well as on the stomach, esophagus, breast, prostate, pancreas, and liver. […] A high-fiber diet is associated with a lower risk of all cancers, a lower risk of cardiovascular and respiratory diseases, and a reduction in all-cause mortality. […] A minimum of 50 grams of fiber a day is needed to promote good health and minimize colon cancer risk. […] The production of butyrate by the gut microbiota through the fermentation of dietary fiber is particularly important. […] Taken together, these actions stimulated by the production of butyrate are anticarcinogenic. […] The study strongly suggested that the level of dietary fiber consumed can convert the colon from a cancer-promoting environment to a cancer-preventing environment in as little as two weeks. […] High-fiber diets have the potential to resolve major public health concerns and allow Americans to live longer and have a better quality of life as they age.

• #2 Prevention | Colorectal Cancer Alliance

  https://colorectalcancer.org/screening-prevention/prevention

  You may be able to lower your colorectal cancer risk with some simple lifestyle changes. Be proactive about staying as healthy as possible. […] While screening is the most important step you can take to prevent colorectal cancer, its not the only one. […] While colorectal cancer can be both genetic and random in nature, there are several proven ways you can reduce your chances of getting this common cancer. […] Diets high in red meat have been linked to colorectal cancer. Try to keep your red meat intake to 18 ounces per week or less. […] Processed meats should be avoided if possible. These meats include hot dogs, ham, bacon, and sausage. Cancer risk increases even with low consumption. […] Diets high in vegetables, fruits and other plant foods reduce risk for many diseases, including colorectal cancer.

• #2 Primary Prevention of Colorectal Cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2947820/

  Limiting intake of processed meat and red meat, especially after high-temperature cooking, and replacing these foods with poultry or fish as alternative protein sources could be a reasonable approach to reducing risk of colorectal cancer. […] Calcium supplementation is likely to be at least modestly beneficial. […] Data support a significant, yet modest ability of calcium intake to prevent colorectal cancer. […] The precise mechanism by which vitamin D prevents colorectal cancer is not clear, but future randomized control trials of higher doses of vitamin D might provide more information. […] Although an association between colorectal cancer and vitamin D has not been definitively proven, it is important to achieve a level of at least 30 ng/mL, since this dose has been shown to be optimal for other health conditions.

• #2 Foods That Fight Colon Cancer: Prevention & Treatment

  https://www.uchealth.com/en/media-room/articles/foods-that-fight-colorectal-cancer-a-guide-to-nutrition-for-prevention-and-treatment

  According to the American Institute for Cancer Research, „Dietary legume consumption reduces the risk of colorectal cancer.” […] According to the American Institute for Cancer Research, there is strong evidence that the consumption of dairy can be protective against colorectal cancer. […] Cancer research suggests the high calcium content in these may be protective. […] If you do drink alcohol, try to do so only occasionally and limit to two standard drinks per day for men or one standard drink per day for women. […] Both red meat and processed meat contain compounds that increase the risk of colon cancer. […] Nutrition and diet play a critical role in fighting cancer and other life-threatening diseases. Many of the same smart food choices that are recommended for reducing the risk of colorectal cancers can be applied to other types of cancer, heart disease or your overall health.

• #2 Colorectal Cancer

  https://www.brgeneral.org/medical-services/gastroenterology/colon-and-rectal-surgery/colorectal-cancer-risk-prevention/

  Colorectal cancer is the second leading cause of cancer-related deaths in both men and women. Routine testing can help prevent colorectal cancer or find it at an early stage, when it’s smaller and easier to treat. […] You may be able to lower your risk with simple lifestyle changes and regular screenings. […] Screening is the #1 way you can prevent colon and rectal cancer. With screening, colorectal cancer is one of the most preventable cancers. Colon cancer and rectal cancer are also highly treatable if caught early. […] Diets high in vegetables, fruits and other plant-based foods reduce the risk for many diseases, including colorectal cancer. […] Adults who increase their physical activity, either in intensity, duration or frequency, can reduce their risk of developing colorectal cancer by 30 to 40%.

• #2 Colorectal Cancer Prevention and Screening | UCSF Health

  https://www.ucsfhealth.org/education/colorectal-cancer-prevention-and-screening

  Maintain a healthy weight. Being obese or overweight increases your chances of developing colorectal cancer. […] Don’t smoke. Smoking cigarettes is linked with a higher risk of colorectal and other types of cancer. […] Avoid alcohol. Not drinking at all may reduce your risk. If you do drink, women should limit consumption to no more than one drink a day, and men to two drinks a day. […] Take a low dose of aspirin daily. Aspirin can reduce the development of polyps, particularly in patients with a previous history of polyps or colorectal cancer. […] Screening is for patients who show no symptoms of cancer. It is a preventive measure that anyone can take to catch abnormal cells early on. […] Polyps usually take about 10 to 15 years to develop into colorectal cancer. If theyre detected early, they can be removed before they turn into cancerous cells. Regular screenings also help to catch cancer cells in their early stages, when treatment is more effective.

• #2 Reducing your risk for colorectal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/colorectal/risks/reducing-your-risk

  You may lower your risk of developing colorectal cancer by doing the following. […] Research shows that regular physical activity can lower your risk for colorectal cancer. […] Research also shows that sedentary time, or sitting time, increases your risk for colorectal cancer. […] Research shows that being overweight or obese increases your risk for colorectal cancer. […] Drinking alcohol increases your risk of developing colorectal cancer. […] Smoking tobacco increases the risk of precancerous conditions and cancer of the colon or rectum. […] Diets that are high in red meat or include processed meats increase the risk for colorectal cancer. […] Research shows that eating foods containing dietary fibre lowers the risk of colorectal cancer. […] Research shows that eating dairy products lowers the risk for colorectal cancer.

• #2 Aspirin for the prevention of colorectal cancer

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3354696/

  Over 600,000 people worldwide die of colorectal cancer (CRC) annually, highlighting the importance of developing effective prevention strategies. Among proposed chemopreventive interventions, aspirin is perhaps the agent with the strongest body of evidence that supports wider spread use to significantly reduce the population burden of CRC. Several epidemiological studies, four randomized controlled trials (RCTs) of colorectal polyp recurrence, and RCTs in patients with hereditary colorectal cancer syndromes, have shown that aspirin reduces incidence of colorectal neoplasia. […] Recently, in a pooled analysis of five cardiovascular-prevention RCTs linked to cancer outcomes, daily aspirin use at any dose reduced the risk of CRC by 24% and of CRC-associated mortality by 35% after a delay of 810 years.

• #2 Should you take aspirin to prevent colorectal cancer? | UCLA Health

  https://www.uclahealth.org/news/article/should-you-take-aspirin-to-prevent-colorectal-cancer

  Excluding skin cancers, colorectal cancer is the third-leading cause of cancer-related deaths in the United States. Regular colorectal cancer screening is the best way to reduce risk. But for certain people, taking a daily low-dose aspirin should also be on your to-do list. […] The U.S. Preventive Services Task Force (USPSTF) finds that low-dose aspirin can reduce the risk of colorectal cancer by 40% for people who meet specific criteria. […] We know that aspirin reduces the risk of colorectal cancer, but we dont recommend it to the general population yet because the benefits dont outweigh the risks for everyone, Dr. Rezapour says. […] Aspirin inhibits several colon cancer-related pathways and inhibits inflammation, which over time leads to cancer, Dr. Rezapour says. […] Aspirin promotes the growth of good bacteria in the gut, Dr. Rezapour says. Those are the bacteria that help prevent colorectal cancer progression and development.

• #2

  https://journals.lww.com/ajg/fulltext/2024/07000/low_dose_aspirin_and_prevention_of_colorectal.29.aspx

  To examine the association between low-dose aspirin use and risk of colorectal cancer (CRC). […] In this nationwide cohort, use of low-dose aspirin was associated with a lower risk of CRC. […] Public health strategies aiming to ease this burden include developing screening programs for prevention and early detection of CRC […] Aspirin has been long regarded as the most promising preventive agent against CRC. […] Regular aspirin use was associated with 27% lower CRC risk. […] Aspirin use was associated with 26% reduced CRC risk. […] The protective effect of aspirin against CRC risk and the optimal pattern of use in the average-risk population remains highly debated. […] We estimated that aspirin use averted 1,073 cases of CRC in the study period. […] Both current use and past use of low-dose aspirin use vs never use were associated with a lower CRC risk.

• #2 Should you take aspirin to prevent colorectal cancer? | UCLA Health

  https://www.uclahealth.org/news/article/should-you-take-aspirin-to-prevent-colorectal-cancer

  One of the biggest issues with aspirin is the risk of GI bleeding that comes with it, according to Dr. Rezapour. […] Both the USPSTF and the ACG stress that you have to be willing or able to take aspirin for at least a decade. The reason is that research shows that we see the full effect of aspirin on colorectal cancer prevention after 10 years of use, Dr. Rezapour says.

• #2 Colorectal cancer prevention: A proven benefit of nonsteroidal anti-inflammatory drugs – Mayo Clinic News Network

  https://newsnetwork.mayoclinic.org/discussion/colorectal-cancer-prevention-a-proven-benefit-of-nonsteroidal-anti-inflammatory-drugs/

  ROCHESTER, Minn. — Mayo Clinic researchers and a team of collaborating scientists from across the country have determined the comparative effectiveness of nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin and several supplements in preventing the recurrence of advanced neoplasia (polyps that are the precursor of colorectal cancer) after polyp removal. […] In their study, published this month in The BMJ, the research team showed that, for most patients, nonaspirin NSAIDs (e.g., ibuprofen) work better than aspirin or a host of nutritional supplements to prevent the growth of advanced adenomas. In the paper, they say that due to most colorectal cancers developing from this type of polyps, preventing them is a good proxy for colorectal cancer prevention. […] “Approximately 85 percent of all colorectal cancers are thought to result from untreated adenomatous polyps,” says M. Hassan Murad, M.D., a clinical epidemiologist and preventive medicine physician at Mayo Clinic, and the study’s senior author. “If we can find a way to stop their growth, we could prevent a majority of these cases.”

• #2 Colorectal Cancer | Cancer Screening and Prevention | Health & Senior Services

  https://health.mo.gov/living/healthcondiseases/chronic/cancer/colorectal-cancer.php

  Cigarette smoking is linked to an increased risk of developing colorectal cancer and death from the disease. […] Studies have shown that taking aspirin lowers the risk of colorectal cancer and the risk of death from colorectal cancer. […] Studies have shown that combination hormone replacement therapy (HRT) that includes both estrogen and progestin lowers the risk of invasive colorectal cancer in postmenopausal women. […] A doctor may consider a patients family health history when deciding which colorectal cancer screening might be appropriate. […] In some cases, colorectal cancer is caused by an inherited genetic condition called Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer or HNPCC. […] It is important for those who have been diagnosed with Lynch syndrome to talk to a doctor about an increased chance of getting other cancers caused by Lynch syndrome.

• #2 Screening and Prevention for People with a Family History of Colorectal Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/health-library/screening-prevention-for-people-with-a-family-history-of-colorectal-cancer

  In people with either one first-degree or two second-degree relatives (for instance, an aunt, uncle or grandparent) with colon cancer or pre-cancerous polyps, the above screening is recommended beginning at age 40 instead of 50, with a colonoscopy as the preferred method. A colonoscopy should be repeated at least every five years if the results are negative. […] Colonoscopy screening should begin at 40 years or 10 years earlier than the earliest case of colon cancer in the family. A colonoscopy should be repeated at least every five years if the results are negative. […] When a hereditary colorectal cancer syndrome is suspected or present in a family, members may begin screening at much younger ages and more frequently. In some cases, screening may begin in childhood or early adulthood and will often involve annual colonoscopy. […] People with a family history of colorectal cancer in several close relatives and across generations, especially if these cancers occur at a young age, may benefit from genetic counseling and genetic testing for the inherited syndromes of colon cancer.

• #2 Preventive Treatment for People at High Risk for Colorectal Cancer | NYU Langone Health

  https://nyulangone.org/conditions/colorectal-cancer/treatments/preventive-treatment-for-people-at-high-risk-for-colorectal-cancer

  Our experts work in partnership with those who are at high risk for colorectal cancer to help make decisions about treatment options and medical and surgical strategies to reduce the risk of cancer. […] Some studies have shown that medications such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), and cox-2 inhibitors may reduce the risk of polyps or colorectal cancer in some people at high risk for colorectal cancer, such as those with IBD. […] People with familial adenomatous polyposis or Lynch syndrome may choose to have surgery to remove the entire colona procedure called a total colectomyto help prevent colon cancer. […] Your doctor may also recommend removing the rectum if he or she is concerned about polyp growths there. This procedure is called a total proctocolectomy.

• #2 Colorectal Cancer Care and Prevention – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/colorectal-cancer-care-and-prevention.asp

  Obesity is defined as a BMI of 30 or greater, and is a risk factor for many solid tumors and chronic diseases. Studies show that both general and central obesity are associated with an increased risk of colorectal cancer, with a stronger association in men. […] Lifestyle modifications are imperative to prevent colorectal cancer. The top modifiable risk factors include exercising 30 minutes most days of the week and adapting a high-fiber diet with five to nine servings of fruits and vegetables per day. Adding garlic, soy, and omega-3 fats to the diet while reducing red meat, processed meat, and simple carbohydrates can have added benefit in the prevention of colorectal cancer. For average-risk patients, screening should start at age 45 with colonoscopy every 10 years, sigmoidoscopy every 5 years, or annual fecal occult blood testing for early detection of precancerous lesions. An anti-inflammatory diet with regular exercise is beneficial for colorectal cancer prevention.

• #2 Colorectal Cancer Prevention | VirginiaNavigator

  https://virginianavigator.org/article/71570/colorectal-cancer-prevention

  Avoiding risk factors and increasing protective factors may help prevent cancer. […] The following risk factors increase the risk of colorectal cancer: Age, Family history of colorectal cancer, Personal history, Inherited risk, Alcohol, Cigarette smoking, Race, Obesity. […] The following protective factors decrease the risk of colorectal cancer: Physical activity, Aspirin, Combination hormone replacement therapy, Polyp removal. […] Cancer prevention clinical trials are used to study ways to prevent cancer. […] New ways to prevent colorectal cancer are being studied in clinical trials.

• #2 Preventing bowel cancer | How you can reduce the risk

  https://www.wcrf.org/preventing-cancer/cancer-types/bowel-cancer/preventing-bowel-cancer/

  Bowel cancer is one of the most common cancers in the UK and worldwide, but it is also one of the most preventable. Making changes to your diet and lifestyle can significantly reduce your risk. […] Around 45% of bowel cancer cases could be prevented by following our Cancer Prevention Recommendations. Here are 6 ways to reduce your bowel cancer risk, based on research from our Global Cancer Update Programme. […] Eating a fibre-rich diet, including wholegrains, can reduce bowel cancer risk. […] Eating processed meat, such as ham, bacon and sausages, and too much red meat, including beef, pork and lamb, increases bowel cancer risk. […] Regular physical activity helps reduce bowel cancer risk by helping you maintain a healthy weight and supporting digestion. […] Maintaining a healthy weight can reduce your risk of 13 different types of cancer, including bowel cancer.

• #2 Colorectal Cancer Screening and Prevention | AAFP

  https://www.aafp.org/pubs/afp/issues/2018/0515/p658.html

  Colorectal cancer is a common cause of morbidity and mortality in the United States. […] The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of age. […] There is good evidence that aspirin, nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 inhibitors, and hormone therapy decrease the risk of colorectal cancer and adenomatous polyps, but potential harms limit their usefulness. […] There is good evidence that calcium supplementation, moderate dairy consumption, reduced red meat consumption, increased physical activity, decreased body mass index, and statin use decrease the risk of colorectal cancer and adenomatous polyps. […] Although increased alcohol intake and tobacco use are associated with an increased risk of colorectal cancer, there is no direct evidence that reducing alcohol consumption or smoking cessation decreases the risk.

Zobacz więcej