Nonsteroidal Anti-inflammatory Drugs and Aspirin for the Prevention of Colorectal Adenomas and Cancer: A Systematic Review

Asano, Tracey K.; McLeod, R. S.

doi:10.1007/s10350-003-0111-9

Cited by 73 publications

(47 citation statements)

References 34 publications

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“…The PPT investigators later reported that use of nonsteroidal anti-inflammatory drugs (NSAID) reduced the odds of both overall adenoma recurrence (OR, 0.77; 95% CI, 0.63-0.95) and recurrence of advanced polyps (OR, 0.56; 95% CI, 0.31-0.99) (2). This finding was consistent with those reported by randomized trials of adenoma recurrence and results from prospective cohort studies (3,4).…”

Section: Introductionsupporting

confidence: 83%

Does Nonsteroidal Anti-inflammatory Drug Use Modify the Effect of a Low-Fat, High-Fiber Diet on Recurrence of Colorectal Adenomas?

Hartman

Albert

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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The Polyp Prevention Trial was designed to evaluate the effects of a high-fiber (18 g/1,000 kcal), high-fruit and -vegetable (3.5 servings/1,000 kcal), low-fat (20% energy) diet on recurrence of adenomatous polyps. Participants z35 years of age, with histologically confirmed colorectal adenoma(s) removed in the prior 6 months, were randomized to the intervention or control group. Demographic, dietary, and clinical information, including use of nonsteroidal anti-inflammatory drugs (NSAID), was collected at baseline and four annual visits. Adenoma recurrence was found in 754 of 1,905 participants and was not significantly different between groups. NSAID use was associated with a significant reduction in recurrence [odds ratio (OR), 0.77; 95% confidence interval (95% CI), 0.63-0.95]. In this analysis, NSAIDs modified the association between the intervention and recurrence at baseline (P = 0.02) and throughout the trial (P = 0.008). Among participants who did not use NSAIDs, the intervention was in the protective direction but did not achieve statistical significance (OR, 0.87; 95% CI, 0.69-1.09). The intervention was protective among males who did not use NSAIDs at baseline (OR, 0.71; 95% CI, 0.54-0.94), but not among NSAIDs users (OR, 1.09; 95% CI, 0.74-1.62). For females, corresponding OR estimates were 1.28 (95% CI, 0.86-1.90) and 2.30 (95% CI, 1.24-4.27), respectively. The protective association observed for NSAID use was stronger among control (OR, 0.63; 95% CI, 0.47-0.84) than for intervention group participants (OR, 0.97; 95% CI, 0.74-1.28). These results should be interpreted cautiously given that they may have arisen by chance in the course of examining multiple associations and Polyp Prevention Trial study participants were not randomly assigned to both dietary intervention and NSAID use. Nevertheless, our results suggest that adopting a low-fat, high-fiber diet rich in fruits and vegetables may lower the risk of colorectal adenoma recurrence among individuals who do not regularly use NSAIDs. (Cancer Epidemiol Biomarkers Prev 2005;14(10):2359-65)

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Section: Introductionsupporting

confidence: 83%

Does Nonsteroidal Anti-inflammatory Drug Use Modify the Effect of a Low-Fat, High-Fiber Diet on Recurrence of Colorectal Adenomas?

Hartman

Albert

et al. 2005

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Given the lack of randomized controlled trials (RCTs) for most of the risk factors, our model assumptions for the relative risks for risk factors were based on the best estimates available from long-term cohort studies. [23][24][25][26][27][28][29][30][31][32] However, RCTs that estimated the effect of nonsteroidal antiinflammatory drugs on adenoma recurrence 63 showed a smaller effect than what was observed from cohort and case-control studies. Thus, in the current study, we may have overestimated the benefits of risk-factor modification.…”

Section: Discussionmentioning

confidence: 89%

How much can current interventions reduce colorectal cancer mortality in the U.S.?

Vogelaar

Ballegooijen

Schrag

et al. 2006

Cancer

172

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BACKGROUND.Although colorectal cancer (CRC) is the second leading cause of cancer death in the U.S., available interventions to reduce CRC mortality are disseminated only partially throughout the population. This study assessed the potential reduction in CRC mortality that may be achieved through further dissemination of current interventions for risk‐factor modification, screening, and treatment.METHODS.The MISCAN‐COLON microsimulation model was used to simulate the 2000 U.S. population with respect to CRC risk‐factor prevalence, screening use, and treatment use. The model was used to project age‐standardized CRC mortality from 2000 to 2020 for 3 intervention scenarios.RESULTS.Without changes in risk‐factor prevalence, screening use, and treatment use after 2000, CRC mortality would decrease by 17% by the Year 2020. If the 1995 to 2000 trends continue, then the projected reduction in mortality would be 36%. However, if trends in the prevalence of risk‐factors could be improved above continued trends, if screening use increased to 70% of the target population, and if the use of chemotherapy increased among all age groups, then a 49% reduction would be possible. Screening drove most (23%) of the projected mortality reduction with these optimistic trends; however, decreasing risk‐factors (16%) and increasing use of chemotherapy (10%) also contributed substantially. The contribution of risk‐factors may have been overestimated, because effect estimates could not be obtained from randomized controlled trials.CONCLUSIONS.Currently available interventions for risk‐factor modification, screening, and treatment have the potential to reduce CRC mortality by almost 50% by the Year 2020. However, without action now to further increase the uptake of current effective interventions, the reduction in CRC mortality may be only 17%. Cancer 2006. © American Cancer Society.

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“…4 | 49 role of inflammation in cancer comes from a large number of epidemiological observations, indicating that regular and prolonged treatment with a vast number of synthetic antiinflammatory drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, can reduce the incidence and recurrence of several human cancers by up to 50% [1,2,3,4,5].…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Inhibition of arachidonic acid metabolism and its implication on cell proliferation and tumour-angiogenesis

Hyde

Missailidis

2009

International Immunopharmacology

143

101

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Lastly, the benefits of dietary omega-3 fatty acids and their mechanisms of action leading to reduced cancer risk and impeded cancer cell growth are mentioned. Finally, a proposal is put forward, suggesting a novel and integrated approach in viewing the molecular mechanisms and complex interactions responsible for the involvement of AA metabolites in carcinogenesis and the protective effects of omega-3 fatty acids in inflammation and tumour prevention.

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Nonsteroidal Anti-inflammatory Drugs and Aspirin for the Prevention of Colorectal Adenomas and Cancer: A Systematic Review

Cited by 73 publications

References 34 publications

Does Nonsteroidal Anti-inflammatory Drug Use Modify the Effect of a Low-Fat, High-Fiber Diet on Recurrence of Colorectal Adenomas?

Does Nonsteroidal Anti-inflammatory Drug Use Modify the Effect of a Low-Fat, High-Fiber Diet on Recurrence of Colorectal Adenomas?

How much can current interventions reduce colorectal cancer mortality in the U.S.?

Inhibition of arachidonic acid metabolism and its implication on cell proliferation and tumour-angiogenesis

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