Aspirin and nonsteroidal anti-inflammatory drug use and the risk of subsequent colorectal cancer

Abstract

The results of previous experimental animal models, interventional case studies, and some but not all epidemiological investigations and the present data point toward a causal relationship between NSAID use and the prevention of cancer of the large bowel and rectum. Because of the potential gastrointestinal and renal side effects of NSAID use, particularly in the elderly, chemoprevention trials are now needed to allow risk-benefit analysis in populations at high risk for colorectal cancer.

Aspirin Dose and Duration of Use and Risk of Colorectal Cancer in Men

“…27,28 Other epidemiological studies generally have found consistent dose relationships for both adenoma [29][30][31][32][33] and cancer. 13,29,[34][35][36][37][38] Although short-term use of aspirin appears to reduce risk of adenoma, [1][2][3]32 we observed that an overall reduction in risk of cancer required more than five years of use. However, because we did not collect data on the number of years of aspirin use at study baseline, duration of use was probably somewhat underestimated.…”

Risk of cancer in a large cohort of nonaspirin NSAID users: a population-based study

“…There is substantial evidence of an inverse association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and the risk of colorectal cancer (Kune et al, 1988;Rosenberg et al, 1991Rosenberg et al, , 1998Thun et al, 1991Thun et al, , 1993Suh et al, 1993;Muscat et al, 1994;Peleg et al, 1994;Schreinemachers et al, 1994;Giovannucci et al, 1995;Smalley et al, 1999;Baron and Sandler, 2000;Coogan et al, 2000;Langman et al, 2000;Rodrigues and Huerta-Alvarez, 2001). A protective effect was initially observed in experimental studies and has been seen in epidemiologic studies of both cohort and casecontrol designs.…”

Aspirin and colorectal cancer

“…Regular aspirin use was reported by only 47 (3.5%) cases and 77 (4.1%) control subjects, giving a multivariate odds ratio (OR) of 0.7 (95% Cl 0.5-1.0) after allowance for education, physical exercise and selected dietary factors.Keywords: aspirin; non-steroidal anti-inflammatory drugs; colorectal neoplasms; pharmacoepidemiology At least six case-control studies (Kune et al, 1988;Rosenberg et al, 1991;Suh et al, 1993;Muscat et al, 1994;Peleg et al, 1994), based on over 3700 cases, have suggested that the risk of colorectal cancer may be reduced in regular aspirin users. Likewise, four (Thun et al, 1991(Thun et al, , 1993Schreinemachers and Everson, 1994;Giovannucci et al, 1994Giovannucci et al, , 1995 out of five (Paganini-Hill et al, 1989;Paganini-Hill, 1994) (Paganini-Hill, 1994;Greenberg and Baron, 1996).…”

“…At least six case-control studies (Kune et al, 1988;Rosenberg et al, 1991;Suh et al, 1993;Muscat et al, 1994;Peleg et al, 1994), based on over 3700 cases, have suggested that the risk of colorectal cancer may be reduced in regular aspirin users. Likewise, four (Thun et al, 1991(Thun et al, , 1993Schreinemachers and Everson, 1994;Giovannucci et al, 1994Giovannucci et al, , 1995 out of five (Paganini-Hill et al, 1989;Paganini-Hill, 1994) cohort studies showed a protection of between 20% and 40% among regular aspirin users, although in the American Nurses' Health Study (Giovannucci et al, 1995) the protection was only evident for frequent use (2 four times per week) and after 20 years of use.…”