Current Status Of Nonsteroidal Anti-Inflammatory Drugs In Colorectal Cancer Prevention

To date, lifestyle modification and screening are the main tools of the CRC preventive strategy. Chemoprevention, i.e. the use of specific agents (natural or chemical) with suggested antineoplastic effect, has been also proposed for the same purpose. Belonging to this category, NSAIDs have been widely investigated within the last two decades, with promising although not (yet) definitive results.[1-3] These agents possibly act through the inhibition of the COX-1 and COX-2 enzymes - both involved in the conversion of arachidonic acid into prostaglandins, metabolites affecting inflammation and multiple potentially tumorigenic cellular processes (proliferation, apoptosis, angiogenesis etc).[4,5] The chemopreventive effect is exerted through retardment, regression or prevention of the development of adenomas (i.e. CRC precursors) resulting in the reduction in both number and size of existing lesions along with protection against new adenoma formation[1-3,5-8], whereas antitumor effect has been also reported in established carcinomas.[3,7]