Table 2 Non-aspirin NSAIDs and colorectal cancer incidence.
From: Non-aspirin non-steroidal anti-inflammatory drugs in colorectal cancer: a review of clinical studies
Study | Design | Patient population | Drug dose and duration | Indication | Key results |
|---|---|---|---|---|---|
Din et al. [26] | Case control study | Healthy adults, mean age 62 years | NA-NSAIDs, any NSAIDs, low-dose aspirin >4 tablets per week for >1 month | CRC incidence | NA-NSAIDs inversely associated with CRC incidence OR 0.74 (95% CI: 0.60–0.90) |
Vinogradova et al. [27] | Nested case control study | Healthy adults, median age of 72 years | NSAIDs including COX2 inhibitors | CRC incidence | Prolonged use (≥25 prescriptions in 13–48 months) of COX2 inhibitors associated with reduction OR 0.34 |
Friis et al. [29] | Population-based cohort study | Healthy adults | Long-term, high-intensity NA-NSAIDs (average daily dose ≥0.3) | CRC incidence | NA-NSAID use associated with a reduction in risk, especially with long-term, high-intensity use of COX2 inhibitors: OR 0.57 (95% CI: 0.44–0.74) |
Mahipal et al. [32] | Prospective cohort study | Postmenopausal women | NA-NSAIDs and aspirin | CRC incidence | NA-NSAIDs associated with a lower incidence HR 0.63 (95% CI: 0.58–1.00) |
Ait Ouakrim et al. [35] | Prospective cohort study | Germline MMR mutations carriers | All NSAIDs—ibuprofen | CRC incidence | Reduced risk with ibuprofen use of 1 month to 4.9 years compared to <1 month of use (HR 0.38); reduction only in proximal CRCs |
Wang et al. [31] | Prospective cohort study | Adults aged >50 years | All NSAIDs ≥4 days per week for ≥4 years | CRC incidence | Use of any NSAIDs associated with lower risk across all subgroups |
Rostom et al. [4] | Systematic review of RCTs, case control and cohort studies | Adults at average or higher risk of CRC* | NA-NSAIDs (COX2 inhibitors) and aspirin | CRC and adenoma incidence | NA-NSAIDs reduced adenoma incidence (cohort RR 0.64, case control RR 0.54) and CRC incidence (cohort RR 0.61, case control 0.70). COX2 inhibitors reduced adenoma incidence (RCT RR 0.72) |
Tomic et al. [34] | Systematic review and meta-analysis | Healthy adults aged 40 years and older | Regular NA-NSAID use^ | CRC incidence | NA-NSAIDs reduced incidence in specific subgroups: -women OR 0.81 (95% CI: 0.67–0.98) -Caucasian OR 0.69 (95% CI: 0.55–0.87) -higher doses OR 0.82 (95% CI: 0.69–0.99) -distal colon cancers OR 0.78 (95% CI: 0.69–0.88) |
