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      A Holistic, Evidence-Based Approach to Preventing Colorectal Cancer with a Focus on Early Detection, Risk Factor Management, Diet, and Lifestyle Modification with an Emphasis on Oral Dysbiosis, Chemoprevention, and Immunoprevention
       
      Sowndarya Madugula1, Prabu D1, Sindhu R1, Dinesh Dhamodhar1, Rajmohan M1, Bharathwaj V V1, Sathiyapriya S1, Premkumar Devdoss2, Yuvaraj Jayaraman3
      1Public health dentistry, SRM Dental college, Chennai. 2Department of Medical Oncology, Govt. Arignar Anna Memorial Cancer hospital, Kanchipuram. 3Scientist G at National Institute of Epidemiology, Ayapakkam, Chennai.


      Corresponding Author
      :
      Prof. Prabu D
      Email: researchphdsrm@gmail.com


      Abstract

      Background: Colorectal cancer is the third most commonly diagnosed and second most deadly cancer in 2020. Although the incidence of disease has decreased among older adults, recently there has been an alarming emergence of early-onset colorectal cancer among people <50 years of age. 9.4% of cancer-related deaths globally occured due to colorectal cancer in 2022. The critical shift in health-care focus from treatment to disease prevention necessitates the development of a well-thought-out integrative prevention strategy that is both practical and evidence-based. The study's goal is to provide a holistic, wellness-oriented disease prevention strategy to reduce the incidence of both early-onset and late-onset colorectal cancer. 
      Materials and Methods: A systematic search from databases (PubMed, Wiley, Elsevier, and Google Scholar) for articles published in the past 7 years in peer-reviewed journals was conducted, aiming at articles regarding risk factors and modification, screening and early detection with biomarkers, diet and lifestyle, traditional and modern chemo-preventive compounds, immunoprevention, and oral dysbiosis. All of the authors independently assessed the quality of the studies. 
      Results: 32 studies, including 13 systematic reviews, 3 cohorts, 3 randomized control trials, 1 case-control, 3 in vitro, 2 in vivo, and 7 reviews. Evidence synthesis is presented as an integrated preventive strategy for colorectal cancer, focusing on different aspects of prevention.
      Conclusion: A holistic approach to CRC prevention should include improved screening, early detection, dietary and lifestyle changes, good communication to perceive risk, need-based nutrition supplementation, and stress management.