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Review
. 2014 Feb 6;5(1):40-9.
doi: 10.4292/wjgpt.v5.i1.40.

Aspirin, cyclooxygenase inhibition and colorectal cancer

Carlos Sostres  1 , Carla Jerusalen Gargallo  1 , Angel Lanas  1
Affiliations
Review

Aspirin, cyclooxygenase inhibition and colorectal cancer

Carlos Sostres et al. World J Gastrointest Pharmacol Ther. .

Abstract

Colorectal cancer (CRC) is the third most common type of cancer worldwide. Screening measures are far from adequate and not widely available in resource-poor settings. Primary prevention strategies therefore remain necessary to reduce the risk of developing CRC. Increasing evidence from epidemiological studies, randomized clinical trials and basic science supports the effectiveness of aspirin, as well as other non-steroidal anti-inflammatory drugs, for chemoprevention of several types of cancer, including CRC. This includes the prevention of adenoma recurrence and reduction of CRC incidence and mortality. The detectable benefit of daily low-dose aspirin (at least 75 mg), as used to prevent cardiovascular disease events, strongly suggests that its antiplatelet action is central to explaining its antitumor efficacy. Daily low-dose aspirin achieves complete and persistent inhibition of cyclooxygenase (COX)-1 in platelets (in pre-systemic circulation) while causing a limited and rapidly reversible inhibitory effect on COX-2 and/or COX-1 expressed in nucleated cells. Aspirin has a short half-life in human circulation (about 20 minutes); nucleated cells have the ability to resynthesize acetylated COX isozymes within a few hours, while platelets do not. COX-independent mechanisms of aspirin have been suggested to explain its chemopreventive effects but this concept remains to be demonstrated in vivo at clinical doses.

Keywords: Aspirin; Benefits; Colorectal cancer; Cyclooxygenase inhibition; Mechanisms; Risk.

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Figures

Figure 1
Figure 1
Balancing risk-benefits for the use of low dose aspirin. CRC: Colorectal cancer; NSAID: Nonsteroidal anti-inflammatory drug; CV: Cardiovascular; PPI: Proton pump inhibitor; ASA: Aspirin.
Figure 2
Figure 2
Cyclooxygenase-dependent mechanisms for antitumoral effects of low dose aspirin. CRC: Colorectal cancer; COX: Cyclooxygenase; PGE2: Prostaglandin E2.
See this image and copyright information in PMC

References

    1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. GLOBOCAN 2008 v1. 2, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet] Lyon, France: International Agency for Research on Cancer; 2011.
    1. Shapiro JA, Seeff LC, Thompson TD, Nadel MR, Klabunde CN, Vernon SW. Colorectal cancer test use from the 2005 National Health Interview Survey. Cancer Epidemiol Biomarkers Prev. 2008;17:1623–1630. - PubMed
    1. United States Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149:627–637. - PubMed
    1. Ajani UA, Ford ES, Greenland KJ, Giles WH, Mokdad AH. Aspirin use among U.S. adults: Behavioral Risk Factor Surveillance System. Am J Prev Med. 2006;30:74–77. - PubMed
    1. National Health Service Information Centre. Prescription cost analysis for England 2007. Available from: http://www.ic.nhs. uk/webfiles/publications/PCA publication/PCA 2007 com....