Colorectal cancer (CRC) prevention has become an important goal for health providers, physicians, and the general public. CRC is a highly prevalent disease that is associated with considerable mortality and morbidity rates, with >1,000,000 new cases and 500,000 deaths expected worldwide in 2006 (1). CRC has a natural history of transition from precursor to malignant lesion that spans 15 to 20 years on average, providing a window of opportunity for effective interventions and prevention. As promising as modern screening tests may be, they are relatively expensive, carry some risk, and require expertise. Most importantly, the level of patient willingness to accept screening is low in many countries, thereby limiting effectiveness.

Early detection of CRC is not an adequate enough objective. Surgery is still required, recurrence is possible, and anxiety persists. Recognition of the ability to prevent CRC by identifying and removing precancerous adenomas has led to a marked...

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