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Can resistant starch and/or aspirin prevent the development of coloi neoplasia? The Concerted Action Polyp Prevention (CAPP) 1 Study

Published online by Cambridge University Press:  05 March 2007

John C. Mathers*
Human Nutrition Research Centre, School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne, NE1 7RU, UK
Ian Mickleburgh
Human Nutrition Research Centre, School of Clinical Medical Sciences, University of Newcastle, Newcastle upon Tyne, NE1 7RU, UK
Pam C. Chapman
Institute of Human Genetics, University of Newcastle, Bioscience Centre, Times Square, Scotswood Road, Newcastle upon Tyne, NE1 4EP, UK
D. Tim Bishop
Genetic Epidemiology Division, Cancer Research UK, University of Leeds, Cancer Genetics Building, St James's University Hospital, Leeds LS9 7TF, UK
John Burn
Institute of Human Genetics, University of Newcastle, Bioscience Centre, Times Square, Scotswood Road, Newcastle upon Tyne, NE1 4EP, UK
*Corresponding author: Professor John Mathers, fax +44 191 222 8684,
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Loss of function of the adenomatous polyposis coli (APC) tumour suppressor gene through truncating mutations or other means is an early event in most colo-rectal cancer (CRC). The AFC gene encodes a large multifunctional protein that plays key roles in several cellular processes, including the wnt signalling pathway where an intact APC protein is essential for down regulation of β-catenin. The APC protein also plays a role in regulation of cell proliferation, differentiation, apoptosis, cell-cell adhesion, cell migration and chromosomal stability during mitosis. Acquisition of a non-functional APC gene can occur by inheritance (in the disease familial adenomatous polyposis (FAP)) or by a sporadic event in a somatic cell. Whilst there is strong epidemiological evidence that variation in diet is a major determinant of variation in CRC incidence, conventional adenoma recurrence trials in sporadic cases of the disease have been relatively unsuccessful in identifying potentially protective food components. Since the genetic basis of CRC in FAP and in sporadic CRC is similar, intervention trials in FAP gene carriers provide an attractive strategy for investigation of potential chemo-preventive agents, since smaller numbers of subjects and shorter time frames are needed. The Concerted Action Polyp Prevention (CAPP) 1 Study is using a 2×2 factorial design to test the efficacy of resistant starch (30 g raw potato starch-Hylon VII (1:1, w/w)/d) and aspirin (600 mg/d) in suppressing colo-rectal adenoma formation in young subjects with FAP. Biopsies of macroscopically-normal rectal mucosa are also being collected for assay of putative biomarkers of CRC risk.

Session: Whole cereal grains, fibre and human cancer
Copyright © The Nutrition Society 2003


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Can resistant starch and/or aspirin prevent the development of coloi neoplasia? The Concerted Action Polyp Prevention (CAPP) 1 Study
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