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Chemoprevention of gastrointestinal malignancies with nonsteroidal antiinflammatory drugs
Author(s) -
Shaheen Nicholas J.,
Straus Walter L.,
Sandler Robert S.
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10333
Subject(s) - medicine , chemoprotective , nonsteroidal , gastroenterology , incidence (geometry) , sulindac , cyclooxygenase , cancer , colorectal cancer , pharmacology , enzyme , biochemistry , chemistry , physics , optics
In multiple studies, the chronic use of nonsteroidal antiinflammatory drugs (NSAIDs) has been associated with a decreased incidence of several types of gastrointestinal (GI) neoplasia. This effect may be mediated by one of several intracellular mechanisms, some of which involve the inhibition of the cyclooxygenase‐2 (COX‐2) isoenzyme. In multiple studies of colorectal carcinoma, chronic NSAID use has shown a protective effect, with the majority of studies demonstrating a 30–70% risk reduction associated with NSAID use. The effect of NSAIDs on other types of GI neoplasia is less clear, but evidence suggests that chronic NSAID use may diminish the risk of esophageal and gastric carcinomas. Data assessing the effects of NSAIDs on the incidence of pancreatic and hepatic malignancies currently are too sparse and inconsistent to draw any conclusions. The newer COX‐2 specific agents may provide a less GI‐toxic alternative to nonselective NSAIDs as chemoprotective agents. Cancer 2002;94:950–63. © 2002 American Cancer Society. DOI 10.1002/cncr.10333