COX‐2 inhibitors and colorectal cancer chemoprevention

Despite recent advances in the understanding of its molecular genetics, colorectal cancer remains one of the worldwide leading causes of cancer death. Compounds with the potential to halt or reverse the carcinogenesis process are being studied as possible chemoprotective agents. Among these agents, non-steroidal anti-inflammatory drugs (NSAID) have been shown to significantly reduce colorectal cancer risk. A new generation of NSAID with specific inhibition towards the isozyme cyclo-oxygenase 2 (COX-2) has been introduced recently to clinical use with the aim of causing fewer adverse effects. Studies using these COX-2 inhibitors have demonstrated a significant chemopreventive effect via various mechanisms. In a short-term randomised controlled trial, these COX-2 inhibitors have also shown encouraging results in patients with familial adenomatous polyposis (FAP). However, further studies are necessary before routine clinical use of this class of agents can be used in the management of FAP patients and other at-risk population groups. Chinese Abstract Figure Chinese Abstract.