ABSTRACT
Cancer rates are tolling high constantly worldwide. High life expectancy, environmental changes, urbanization, and changing lifestyles have been vital contributive factors for the hike in carcinogenesis. Carcinogenesis is a complex process that involves numerous pathways that bring oncogenetic transformation in the normal 62cells and render them unassailably viable. The cancer cells undergo unlimited replication due to growth signal autonomy, evasion of growth and inhibitory signals, evasion of apoptosis, invasion, metastasis, and sustained angiogenesis [1]. The fact that cancer cells are very similar to the normal human cells makes them a very difficult target. In spite of extensive research and development in the field of oncology, it still remains a big challenge to prevent, treat, or mitigate this disease. Among several cancer subtypes, one of the highly incidental and preventive cancer is the colorectal cancer (CRC). As per American Cancer Society’s (ACS) statistical data, CRC is the third most common cancer worldwide. CRC is one of the most lethal cancers contributing to about 7,000,000 annual cancer-related deaths [2]. The ACS has estimated an astounding statistics that claims 97,220 new cases of colon and 43,030 new cases of rectal cancer present every year. Their extrapolated estimates for 2018 presented a lifetime risk of about 1 in 22 men and 1 in 24 women to be suffering from CRC. The global burden of CRC is expected to increase by 60 % till 2030; expecting about 2.2 million new cases and about 1.1 million deaths. Out of several risk factors that are believed to contribute to the pathogenesis of this lethal disease, diet and lifestyle have been realized to have a principal role. Lifestyle was identified to be a leading cause, with contribution to etiology of about 90%–95% of all cancers, while only 5%–10% was found to be due to genetic fault [3,4]. The latest CRC report 2017, generated by World Cancer Research Fund International in coalition with the American Institute of Cancer Research has emphasized the role of diet, weight, and physical activity in the prevention and control of CRC [5]. A global scientific research was undertaken by World Cancer research fund international as a part of Continuous Update Project (CUP) to establish the association of the above-mentioned factors in the development and prevention of CRC. The study has underpinned the research findings from over 99 worldwide studies, comprising of more than 29 million adults and over 2,47,000 cases. The incidence and death statistics results were found to vary by about 10-fold worldwide owing to regional and lifestyle disparities. Surprisingly, the trends and patterns of CRC were found to strongly corelate with food and lifestyles. For instance, the incidental rates of CRC in Indian subcontinent (30 cases per million) was radically less than the incidental rates of CRC worldwide (530 cases per million). This striking difference in the incidence rates was a subject of several research works that tried to explore the underlying reasons. Indian environment, lifestyle, and diet were the common reasons that justified the low CRC rates in India. Indian diet in contrast to the Western diet was found to be rich in dietary fiber, probiotics, and spices that might play a vital role in CRC epidemiology. Also, vegetarianism and lower red meat intake were found to have been linked to the prevention of the CRC incidence in the Indian subpopulation [6].
