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NSAIDs and colorectal cancer prevention

Takeo Iwama1

  • 1Kyoundo Hospital, Sasaki Foundation, 1-8 Kanda Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.

Journal of Gastroenterology
|January 17, 2009
PubMed

Insights

Nonsteroidal anti-inflammatory drugs (NSAIDs), particularly cyclooxygenase (COX)-2 inhibitors, show promise for colorectal cancer prevention. Higher doses of COX-2 inhibitors effectively suppress adenoma, but moderate doses lack clinical efficacy.

Area of Science:

  • Oncology
  • Gastroenterology
  • Pharmacology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) have demonstrated a suppressive effect on colorectal tumors since 1981.
  • The chemopreventive action of NSAIDs is linked to their inhibition of prostaglandin synthesis.

Purpose of the Study:

  • To review the chemopreventive effects of NSAIDs, including cyclooxygenase (COX)-2 inhibitors, for colorectal cancer prevention.
  • To present findings from clinical trials on COX-2 inhibitors for adenoma regression in familial adenomatous polyposis (FAP).

Main Methods:

  • Review of existing literature on NSAIDs and colorectal cancer chemoprevention.
  • Analysis of a randomized double-blind clinical trial investigating a COX-2-specific inhibitor's effect on FAP adenoma.
  • Inclusion of clinical guidelines for NSAID use in colorectal cancer prevention.

Main Results:

  • Higher doses of COX-2 inhibitors demonstrate a suppressive effect on colorectal adenoma.
  • Moderate clinical doses of COX-2 inhibitors did not achieve clinically effective adenoma suppression.
  • NSAIDs may be explored in combination therapies for future colorectal cancer prevention strategies.

Conclusions:

  • COX-2 inhibitors hold potential for colorectal cancer prevention, with dose-dependency observed.
  • Further research into combination therapies involving NSAIDs is warranted for enhanced chemoprevention.

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