NSAIDs and gastrointestinal cancer prevention - PubMed (original) (raw)

Review

NSAIDs and gastrointestinal cancer prevention

Kate Jolly et al. Drugs. 2002.

Abstract

Numerous studies report the relationship between aspirin and other nonsteroidal anti-inflammatories (NSAIDs) and cancer incidence, in particular for colorectal cancer. This paper systematically reviews the evidence of the effect of aspirin and other NSAIDs on the primary prevention of colorectal and other gastrointestinal cancers in the general population. In 25 investigations of NSAIDs and colorectal cancer, 23 observational studies reported a relative risk reduction but estimates vary widely. Cohort studies generally indicate lesser reductions than case-control studies suggesting possible biases in the latter. Clear evidence of a dose relationship generally appears lacking but data do not indicate useful effects of aspirin in cardioprophylactic doses. Differences have otherwise not been detected between aspirin and other NSAIDs, nor between non-aspirin NSAIDs. There is some evidence that the risk of colorectal cancer reduces with increased duration of NSAID use. The lower incidence of oesophageal and gastric cancers results in smaller numbers of cases in the studies reporting these cancers, particularly in the cohort studies. The trend is for a risk reduction for oesophageal and gastric cancers in people taking NSAIDs, which is more likely to be statistically significant in the case-control studies. A very small number of observational studies have reported the relationship between NSAIDs and the incidence of pancreatic, gallbladder and liver cancers. These show no consistent relationship. In view of the inadequate information about optimal dose and duration of NSAIDs for colorectal cancer reduction, and the adverse effects of NSAIDs, we are not yet in a position to recommend NSAIDs for the primary prevention of colorectal cancer in the general population.

PubMed Disclaimer

Similar articles

Cited by

References

    1. Cancer Res. 1995 Jul 15;55(14):3110-6 - PubMed
    1. J Natl Cancer Inst. 1993 Aug 4;85(15):1220-4 - PubMed
    1. Cancer Res. 1999 Sep 1;59(17):4356-62 - PubMed
    1. Cancer Res. 1988 Aug 1;48(15):4399-404 - PubMed
    1. Br J Cancer. 2001 Apr 6;84(7):965-8 - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources