Nonsteroidal Anti-inflammatory Drugs and Cyclooxygenase-2 Inhibitors for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force

Established in 1927 by the American College of Physicians

Abstract/Editors' Note | Full Text | PDF

FIGURES/TABLES SUMMARY PAGE

PowerPoint slides are available for most Figures at Annals.org

Nonsteroidal Anti-inflammatory Drugs and Cyclooxygenase-2 Inhibitors for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force

View this table:
[in this window]
[in a new window]

Appendix Table 1. Confounders Addressed in Adjusted Relative Risks among the Included Case–Control Studies: Use of Nonaspirin Nonsteroidal Anti-inflammatory Drugs and the Risk for Adenomas* ${webonly}$

View this table:
[in this window]
[in a new window]

Appendix Table 2. Confounders Addressed in Adjusted Relative Risks among the Included Case–Control Studies: Duration of Nonaspirin Nonsteroidal Anti-inflammatory Drug (NSAID) Use and the Risk for Adenomas* ${webonly}$

View larger version (38K):
[in this window]
[in a new window]

Figure. Study flow diagram.

Studies not shown but included were acetylsalicylic acid (ASA) studies or studies that considered more than 1 intervention, outcome, or both. The Nurses' Health Study (NHS) represents an initial publication (46) and a follow-up publication (34) for colorectal cancer (CRC) and a separate publication for colorectal adenoma (CRA) (47). Three cyclooxygenase (COX)-2 inhibitor polyp studies and a systematic review were added after we submitted our report to the U.S. Preventive Services Task Force and the Agency for Health Research and Quality. *11 of these considered harms of ASA. CV = cardiovascular; NSAID = nonsteroidal anti-inflammatory drug; RCT = randomized, controlled trial.

View this table:
[in this window]
[in a new window]

Appendix Table 3. Nonsteroidal Anti-inflammatory Drug (NSAID) Chemoprevention of Colonic Adenomas: Included Randomized, Controlled Trials* ${webonly}$

View this table:
[in this window]
[in a new window]

Appendix Table 4. Nonsteroidal Anti-inflammatory Drug (NSAID) Chemoprevention of Colonic Adenomas and Colorectal Cancer (CRC): Included Cohort Studies* ${webonly}$

View this table:
[in this window]
[in a new window]

Appendix Table 5. Nonsteroidal Anti-inflammatory Drug (NSAID) Chemoprevention of Colonic Adenomas and Colorectal Cancer (CRC): Included Case–Control Studies* ${webonly}$

View this table:
[in this window]
[in a new window]

Table 1. Chemopreventive Efficacy of Regular Use of Nonsteroidal Anti-inflammatory Drugs (NSAID)*

View this table:
[in this window]
[in a new window]

Table 2. Dose–Response Effects of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) on the Incidence of Colorectal Cancer (CRC) and Adenomas*

View this table:
[in this window]
[in a new window]

Table 3. Effects of Duration of Regular Nonsteroidal Anti-inflammatory Drug (NSAID) Use on the Incidence of Colorectal Cancer (CRC) and Adenomas*

View this table:
[in this window]
[in a new window]

Table 4. Cardiovascular Harms of Non–Acetylsalicylic Acid (ASA) Nonsteroidal Anti-inflammatory Drugs (NSAIDs) and Cyclooxygenase (COX)-2 Inhibitors*