Abstract
BackgroundEpidemiologic and laboratory investigations suggest that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have chemopreventive effects against colon cancer perhaps due at least in part to their activity against cyclooxygenase-2 (COX-2), the rate-limiting enzyme of the prostaglandin cascade.MethodsWe conducted a case control study of colon cancer designed to compare effects of selective and non-selective COX-2 inhibitors. A total of 326 incident colon cancer patients were ascertained from the James Cancer Hospital, Columbus, Ohio, during 2003–2004 and compared with 652 controls with no history of cancer and matched to the cases at a 2:1 ratio on age, race, and county of residence. Data on the past and current use of prescription and over the counter medications and colon cancer risk factors were ascertained using a standardized risk factor questionnaire. Effects of COX-2 inhibiting agents were quantified by calculating odds ratios (OR) and 95% confidence intervals.ResultsResults showed significant risk reductions for selective COX-2 inhibitors (OR = 0.31, 95% CI = 0.16–0.57), regular aspirin (OR = 0.33, 95% CI = 0.20–0.56), and ibuprofen or naproxen (0.28, 95% CI = 0.15–0.54). Acetaminophen, a compound with negligible COX-2 activity and low dose aspirin (81 mg) produced no significant change in the risk of colon cancer.ConclusionThese results suggest that both non-selective and selective COX-2 inhibitors produce significant reductions in the risk of colon cancer, underscoring their strong potential for colon cancer chemoprevention.
Highlights
Epidemiologic and laboratory investigations suggest that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have chemopreventive effects against colon cancer perhaps due at least in part to their activity against cyclooxygenase-2 (COX-2), the rate-limiting enzyme of the prostaglandin cascade
A significant reduction in the risk of colon cancer was observed for daily intake of selective COX-2 inhibitors for one year or more (Adjusted odds ratios (OR) = 0.31, 95% CI = 0.16–0.57)
Joint use of COX-2 inhibitors with aspirin or other NSAIDs was reported by 9.4% of subjects; the odds ratio for COX-2 inhibitors was not appreciably changed with additional adjustment for the prior intake of such compounds (OR = 0.40, 95% CI = 0.25–0.82)
Summary
Epidemiologic and laboratory investigations suggest that aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) have chemopreventive effects against colon cancer perhaps due at least in part to their activity against cyclooxygenase-2 (COX-2), the rate-limiting enzyme of the prostaglandin cascade. Among American men and women, colon cancer is the third most frequently diagnosed malignancy and third leading cause of cancer death [1]. In the past two decades, incidence and mortality rates for colon cancer have declined by more than 20% in women and men [1,2]. One factor that may have contributed to these declines is the widespread intake of aspirin, ibuprofen and other nonsteroidal antiinflammatory drugs (NSAIDs)[3]. Among 22 published epidemiologic studies that focused on the association between intake of NSAIDs and the risk of human colon cancer, 20 reported statistically significant risk reductions. Meta-analysis of these data suggests that regular NSAID (page number not for citation purposes)
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