NSAIDs and Colorectal Cancer Control: Promise and Challenges.

摘要: The chemoprevention of colorectal cancer (CRC) is a realistic option given the low acceptance and cost screening colonoscopy. NSAIDs, currently not recommended for CRC prevention, are most promising agents. Here, we review relevant work assess chemopreventive potential NSAIDs. efficacy NSAIDs established by epidemiological interventional studies as well analyses cardiovascular-prevention randomized clinical trials. modest compounded their significant toxicity that can be cumulative. Efforts to overcome these limitations include use drug combinations; emphasis on early stages colon carcinogenesis such aberrant crypt foci, which may require shorter periods administration; development several families chemically modified derivatives sulindac, nitro-NSAIDs phospho-NSAIDs, with some them appearing have higher safety than conventional thus better candidate successful agents will likely combination following: identification subjects at high risk and/or those benefit from chemoprevention; optimization timing, dose duration administration agent; novel NSAID combinations agents; prevent other diseases in addition CRC. Ultimately, implementation prevention depend strategy drastically shifts unacceptable risk/benefit ratio favor chemoprevention.