Extracting the benefits of berberine for colorectal cancer

Colorectal cancer was the third most common cancer and the second leading cause of cancer death worldwide in 2018. Although screening for colorectal cancer and precancerous adenomatous polyps (adenomas) has been successful in reducing colorectal cancer mortality, there are barriers to widespread implementation, associated harms, and inherent limitations to efficacy. Thus, novel strategies for prevention remain an important unmet need. Chemoprevention, defined as the use of agents (eg, medications, vitamins, or supplements) for the inhibition, delay, or reversal of carcinogenesis, is an appealing alternative or complement to screening, particularly in resource-limited settings. In 2016, the US Preventive Services Task Force recommended low-dose aspirin for the prevention of cardiovascular events and colorectal cancer in certain age groups with specific cardiovascular risk profiles. 1 Bibbins-Domingo K on behalf of the US Preventive Services Task ForceAspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2016; 164: 836 Crossref PubMed Google Scholar However, concerns regarding potential adverse effects of aspirin have sustained interest in additional chemopreventive agents, including natural products such as berberine, an isoquinoline quaternary alkaloid extracted from many medicinal plants. Berberine versus placebo for the prevention of recurrence of colorectal adenoma: a multicentre, double-blinded, randomised controlled studyBerberine 0·3 g twice daily was safe and effective in reducing the risk of recurrence of colorectal adenoma and could be an option for chemoprevention after polypectomy. Full-Text PDF