Ibuprofen Could be the Key to Colorectal Cancer Prevention

Nonsteroidal anti-inflammatory drugs effective in preventing advanced neoplasia recurrence.

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been proven to be beneficial in the prevention of advanced neoplasia recurrence after polyp removal.

Advanced neoplasia are polyps that are the precursor of colorectal cancer. In fact, more than one-third of individuals with colorectal cancer will die of the disease, with most of those cancers arising from advanced neoplasia, accord to the World Cancer Research Fund.

In a study published in The BMJ, investigators sought to demonstrate the superiority of nonaspirin NSAIDs compared with aspirin or nutritional supplements to prevent the growth of advanced adenomas.

“Approximately 85% of all colorectal cancers are thought to result from untreated adenomatous polyps,” said senior author Hassan M. Murad, MD. “If we can find a way to stop their growth, we could prevent a majority of these cases.”

Preventing polyp growth is a good proxy for colorectal cancer prevention, according to the authors. This is because most colorectal cancers develop from this type of polyp.

“We knew that aspirin and other NSAIDs have a protective effect, and that a number of other nutritional supplements have also been studied for their effectiveness in preventing cancer,” Dr Murad said. “What we didn’t know is how they compared to each other.”

The investigators conducted a meta-analysis of data from 15 randomized, controlled clinical trials that included 12,234 patients. The studies included low- and high-dose aspirin therapy, folic acid, vitamin D, and calcium. Each were compared alone or in various combinations, according to the study.

The results showed that within 3 to 5 years following the initial polyp removal, the nonaspirin NSAIDs were more effective in preventing recurrence of adenomatous polyps than all the other compared therapies.

The study authors noted that since nonaspirin NSAIDs do have some adverse effects, it might not be a suitable option for everyone. Aspirin had nearly similar results, with much less added risk, according to the authors. However, Dr Murad cautions that although low-dose aspirin was ranked second in preventive capabilities, “the excess benefit over risk might therefore be favorable for many patients.”

“It is important that patients and doctors have a discussion on the various risks and benefits of any medication or other therapy,” Dr Murad added. “While a research publication may contain promising findings, it is generalized information, and each individual is different. So their care will be individualized, as well.”