Abstract
Simple SummaryThere is growing evidence from epidemiologic, preclinical and clinical studies suggesting that non-steroidal anti-inflammatory drugs (NSAIDs) play a beneficial role in colorectal cancer chemoprevention. They reduce the risk of colorectal polyps, mostly by cyclooxygenase-2 inhibition. The aim of our work was to describe the current state of scientific knowledge on the potential added value of the use of NSAIDs (such as aspirin, sulindac, and celecoxib) as chemopreventive agents in patients at risk of colorectal cancer. The study confirmed that there is a link between the long-term use of the NSAIDs and a decrease in the risk of colorectal cancer.Since colorectal cancer is one of the world’s most common cancers, studies on its prevention and early diagnosis are an emerging area of clinical oncology these days. For this study, a review of randomized controlled, double-blind clinical trials of selected NSAIDs (aspirin, sulindac and celecoxib) in chemoprevention of colorectal cancer was conducted. The main molecular anticancer activity of NSAIDs is thought to be a suppression of prostaglandin E2 synthesis via cyclooxygenase-2 inhibition, which causes a decrease in tumor cell proliferation, angiogenesis, and increases apoptosis. The lower incidence of colorectal cancer in the NSAID patients suggests the long-lasting chemopreventive effect of drugs studied. This new approach to therapy of colorectal cancer may transform the disease from a terminal to a chronic one that can be taken under control.
Highlights
Colorectal cancer (CRC) is one of the most common human malignancies in the Western countries, being the world’s fourth most deadly malignancy [1]
A multicenter Children’s International Polyposis (CHIP) study was conducted in children (10–17 years) with familial adenomatous polyposis (FAP) to assess the safety and efficacy of celecoxib in preventing the development of colorectal polyps compared to placebo during the five-year treatment
The complete anticancer strategy will probably evolve into more sophisticated methods of management of higher-risk individuals and a more personalized approach
Summary
Colorectal cancer (CRC) is one of the most common human malignancies in the Western countries, being the world’s fourth most deadly malignancy [1]. The inflammation and the angiogenesis are host-dependent cancer hallmarks that can be targeted using preventive approaches long before tumors initiate and progress [13,14]. It was defined as the use of natural, synthetic or biological agents to reverse, suppress or prevent either the initial phases of carcinogenesis or progression of premalignant cells to Cancers 2021, 13, 594. Because of increased risk of vascular events, long-term use (more than 5 years) of COX-2 inhibitors in prevention is rather not feasible (more feasible is aspirin use) [42]. Low-dose aspirin (COX-1 inhibitor) therapy inhibits TXA2-dependent platelet function, that is why patients are taking it to prevent myocardial infarction, but antiplatelet effect of this drug might increase the risk of bleeding during a subsequent operation [43]. NSAIDs may impair the therapeutic benefits of ACE inhibitors and β-blockers by inhibiting prostaglandins biosynthesis in the kidneys, which results in impaired vasodilatation, decreased renal function, sodium and water retention which may cause edema [39]
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