Colorectal cancer, aspirin and NSAIDS
The most obvious examples of chronic inflammation causing cancer are seen in patients with inflammatory bowel disease (ulcerative colitis and Crohn’s disease)
- These patients have an increased risk of developing colorectal cancer.
- They require annual screening colonoscopy to screen for cancer due to their high risk of developing colorectal cancer.
There are many studies that demonstrate possible benefit of aspirin as well as non-steroidal anti-inflammatory drugs (NSAIDS) in reducing the risk of colorectal cancer.
In patients with familiar adenomatous polyposis (FAP, a hereditary cancer syndrome), sulindac (an old NSAID) and celebrex have been shown to reduce the size and number of polyps.
- Celebrex can also reduce the risk of sporadic colorectal adenomas.
Despite the known benefit in reducing the risk of adenomas and colon cancer:
- the clinical guidelines by the U.S. Preventive Services Task Force cautions that these agents are associated with important cardiovascular events and gastrointestinal harms.
- The balance of benefits to risk does not favor chemoprevention in average-risk individuals.
For more information, follow the link to the Clinical Guidelines by the U.S. Preventive Services Task Force:
- Aspirin, Nonsteroidal Anti-inflammatory Drugs and Cyclooxygenase-2 Inhibitors for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force (published in 2007).
