Colorectal cancer prevention by non-steroidal anti-inflammatory drugs: effects of dosage and timing.

Publisher: Nature Publishing Group on behalf of Cancer Research UK Country of Publication: England NLM ID: 0370635 Publication Model: Print Cited Medium: Print ISSN: 0007-0920 (Print) Linking ISSN: 00070920 NLM ISO Abbreviation: Br J Cancer Subsets: MEDLINE

Publication: 2002- : London : Nature Publishing Group on behalf of Cancer Research UK
Original Publication: London, Lewis.

Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage ; Anticarcinogenic Agents/*administration & dosage ; Colonic Neoplasms/*prevention & control ; Rectal Neoplasms/*prevention & control; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Anticarcinogenic Agents/therapeutic use ; Case-Control Studies ; Cohort Studies ; Colonic Neoplasms/epidemiology ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Female ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/epidemiology ; Risk Factors ; Saskatchewan/epidemiology

Epidemiological studies show that non-steroidal anti-inflammatory drugs (NSAIDs) reduce colorectal cancer incidence. We measured the rate ratio for colorectal adenocarcinoma according to dosage and the timing of exposure by means of a case-control study, nested in a non-concurrent cohort linkage study, using the population of beneficiaries of the Saskatchewan Prescription Drug Plan from 1981 to 1995 with no history of cancer since 1970 as the source population. Four controls per case, matched on age and gender and alive when the case was diagnosed, were randomly selected. Dispensing rates, calculated over successive time periods, characterized NSAID exposure. We accrued 3844 cases of colon cancer and 1971 cases of rectal cancer. For colon cancer a significant trend towards a decreasing rate ratio was associated with increasing exposure during the 6 months preceding diagnosis (P-trend = 0.002). For both cancers, significant trends were associated with exposure 11-15 years before diagnosis (colon: P-trend = 0.01; rectum: P-trend = 0.0001). At the highest exposure levels the rate ratio for colon cancer was 0.57 (95% confidence interval (CI) 0.36-0.89); for rectal cancer it was 0.26 (95% CI 0.11-0.61). No protection was associated with exposure during other periods. The timing of NSAID use must be considered in planning intervention trials to prevent colorectal cancer. There may be a 10-year delay before any preventive effect will appear.

Comment in: Br J Cancer. 1999 Sep;81(1):1-2. (PMID: 10487603)

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0 (Anti-Inflammatory Agents, Non-Steroidal)
0 (Anticarcinogenic Agents)

Date Created: 19990916 Date Completed: 19990930 Latest Revision: 20181113

20221213

PMC2374346

10.1038/sj.bjc.6690651

10487613