Potential role of acetylsalicilic acid and other non-steroidal anti-inflammatory drugs in cancer risk reduction (literature review)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2021.3.209851

Keywords:

acetylsalicylic acid, non-steroidal anti-inflammatory drugs, cancer risk

Abstract

The aim of this review is to analyze and summarize the existing evidence regarding the possibilities of using acetylsalicylic acid (ASA) and other non-steroidal anti-inflammatory drugs (NSAIDs) to reduce cancer risk.

Conclusions. Chronic inflammation facilitates the onset and progress of tumour growth. Anti-cancer properties of acetylsalicylic acid and other non-steroidal anti-inflammatory drugs are mediated via cyclooxygenase COX-dependent mechanisms, as well as other tumorigenic pathways. Current systematic review addresses potential role of ASA and other NSAIDs in reduction of cancer risk for the following localizations: head and neck, lungs, gastrointestinal tract, breast, ovaries, prostate, and skin. The role of ASA in primary prevention of colorectal cancer in specific populations is presented in 2016 U. S. Preventive Services Task Force guidelines. Studies indicate heterogeneous protective potential of ASA against different cancer types, depending on studied population, duration of intake and dose. Influence of non-aspirin NSAIDs on cancer morbidity and mortality is more controversial.

Author Biographies

V. V. Buheruk, Odesa National Medical University, Ukraine

MD, PhD, Associate Professor of the Department of General Practice

O. B. Voloshyna, Odesa National Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of General Practice

L. I. Kovalchuk, Odesa National Medical University, Ukraine

MD, PhD, Associate Professor of the Department of General Practice

I. V. Balashova, Odesa National Medical University, Ukraine

MD, PhD, Senior Researcher, Assistant of the Department of General Practice

O. V. Naidionova, Odesa National Medical University, Ukraine

MD, PhD, Assistant of the Department of General Practice

References

  1. Khandia, R., & Munjal, A. (2020). Chapter Six - Interplay between inflammation and cancer. In R. Donev (Ed.), Advances in protein chemistry and structural biology (Vol. 119, pp. 199-245). Academic Press. https://doi.org/10.1016/bs.apcsb.2019.09.004
  2. Baron, J. A. (2003). Epidemiology of non-steroidal anti-inflammatory drugs and cancer. In A. J. Dannenberg & R. N. DuBois (Eds.), Progress in Experimental Tumor Research (Vol. 37, pp. 1-24). Basel, Karger. https://doi.org/10.1159/000071364
  3. Zappavigna, S., Cossu, A. M., Grimaldi, A., Bocchetti, M., Ferraro, G. A., Nicoletti, G. F., Filosa, R., & Caraglia, M. (2020). Anti-Inflammatory Drugs as Anticancer Agents. International Journal of Molecular Sciences, 21(7), Article 2605. https://doi.org/10.3390/ijms21072605
  4. Usman, M. W., Luo, F., Cheng, H., Zhao, J. J., & Liu, P. (2015). Chemopreventive effects of aspirin at a glance. Biochimica et Biophysica Acta, 1855(2), 254-263. https://doi.org/10.1016/j.bbcan.2015.03.007
  5. Gay, L. J., & Felding-Habermann, B. (2011). Contribution of platelets to tumour metastasis. Nature Reviews Cancer, 11(2), 123-134. https://doi.org/10.1038/nrc3004
  6. Schrör, K., & Rauch, B. H. (2013). Acetylsalicylsäure und Prävention kolorektaler Karzinome. Der Internist, 54(7), 884-891. https://doi.org/10.1007/s00108-013-3311-y
  7. Saxena, P., Sharma, P. K., & Purohit, P. (2020). A journey of celecoxib from pain to cancer. Prostaglandins & Other Lipid Mediators, 147, Article 106379. https://doi.org/10.1016/j.prostaglandins.2019.106379
  8. Wang, D., Fu, L., Sun, H., Guo, L., & DuBois, R. N. (2015). Prostaglandin E2 Promotes Colorectal Cancer Stem Cell Expansion and Metastasis in Mice. Gastroenterology, 149(7), 1884-1895.e4. https://doi.org/10.1053/j.gastro.2015.07.064
  9. Tołoczko-Iwaniuk, N., Dziemiańczyk-Pakieła, D., Nowaszewska, B. K., Celińska-Janowicz, K., & Miltyk, W. (2019). Celecoxib in Cancer Therapy and Prevention - Review. Current Drug Targets, 20(3), 302-315. https://doi.org/10.2174/1389450119666180803121737
  10. Vallée, A., Lecarpentier, Y., & Vallée, J. N. (2019). Targeting the Canonical WNT/β-Catenin Pathway in Cancer Treatment Using Non-Steroidal Anti-Inflammatory Drugs. Cells, 8(7), Article 726. https://doi.org/10.3390/cells8070726
  11. Tsoi, K., Ho, J., Chan, F., & Sung, J. (2019). Long-term use of low-dose aspirin for cancer prevention: A 10-year population cohort study in Hong Kong. International Journal of Cancer, 145(1), 267-273. https://doi.org/10.1002/ijc.32083
  12. Loomans-Kropp, H. A., Pinsky, P., Cao, Y., Chan, A. T., & Umar, A. (2019). Association of Aspirin Use With Mortality Risk Among Older Adult Participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. JAMA Network Open, 2(12), Article e1916729. https://doi.org/10.1001/jamanetworkopen.2019.16729
  13. McNeil, J. J., Nelson, M. R., Woods, R. L., Lockery, J. E., Wolfe, R., Reid, C. M., Kirpach, B., Shah, R. C., Ives, D. G., Storey, E., Ryan, J., Tonkin, A. M., Newman, A. B., Williamson, J. D., Margolis, K. L., Ernst, M. E., Abhayaratna, W. P., Stocks, N., Fitzgerald, S. M., Orchard, S. G., … ASPREE Investigator Group. (2018). Effect of Aspirin on All-Cause Mortality in the Healthy Elderly. The New England Journal of Medicine, 379(16), 1519-1528. https://doi.org/10.1056/NEJMoa1803955
  14. Zheng, S. L., & Roddick, A. J. (2019). Association of Aspirin Use for Primary Prevention With Cardiovascular Events and Bleeding Events: A Systematic Review and Meta-analysis. JAMA, 321(3), 277-287. https://doi.org/10.1001/jama.2018.20578
  15. de la Cour, C. D., Dehlendorff, C., Aalborg, G. L., von Buchwald, C., Friis, S., Verdoodt, F., & Kjaer, S. K. (2020). Use of nonaspirin nonsteroidal anti-inflammatory drugs and risk of head and neck cancer: A nationwide case-control study. International Journal of Cancer, 146(8), 2139-2146. https://doi.org/10.1002/ijc.32544
  16. Brusselaers, N., & Lagergren, J. (2018). Maintenance use of non-steroidal anti-inflammatory drugs and risk of gastrointestinal cancer in a nationwide population-based cohort study in Sweden. BMJ Open, 8(7), Article e021869. https://doi.org/10.1136/bmjopen-2018-021869
  17. Drew, D. A., Cao, Y., & Chan, A. T. (2016). Aspirin and colorectal cancer: the promise of precision chemoprevention. Nature Reviews Cancer, 16(3), 173-186. https://doi.org/10.1038/nrc.2016.4
  18. Cole, B. F., Logan, R. F., Halabi, S., Benamouzig, R., Sandler, R. S., Grainge, M. J., Chaussade, S., & Baron, J. A. (2009). Aspirin for the chemoprevention of colorectal adenomas: meta-analysis of the randomized trials. Journal of the National Cancer Institute, 101(4), 256-266. https://doi.org/10.1093/jnci/djn485
  19. Giardiello, F. M., Hamilton, S. R., Krush, A. J., Piantadosi, S., Hylind, L. M., Celano, P., Booker, S. V., Robinson, C. R., & Offerhaus, G. J. (1993). Treatment of Colonic and Rectal Adenomas with Sulindac in Familial Adenomatous Polyposis. The New England Journal of Medicine, 328(18), 1313-1316. https://doi.org/10.1056/NEJM199305063281805
  20. Rothwell, P. M., Wilson, M., Elwin, C. E., Norrving, B., Algra, A., Warlow, C. P., & Meade, T. W. (2010). Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. The Lancet, 376(9754), 1741-1750. https://doi.org/10.1016/S0140-6736(10)61543-7
  21. Cao, Y., Nishihara, R., Wu, K., Wang, M., Ogino, S., Willett, W. C., Spiegelman, D., Fuchs, C. S., Giovannucci, E. L., & Chan, A. T. (2016). Population-wide Impact of Long-term Use of Aspirin and the Risk for Cancer. JAMA Oncology, 2(6), 762-769. https://doi.org/10.1001/jamaoncol.2015.6396
  22. Friis, S., Riis, A. H., Erichsen, R., Baron, J. A., & Sørensen, H. T. (2015). Low-Dose Aspirin or Nonsteroidal Anti-inflammatory Drug Use and Colorectal Cancer Risk: A Population-Based, Case-Control Study. Annals of Internal Medicine, 163(5), 347-355. https://doi.org/10.7326/M15-0039
  23. Veettil, S. K., Nathisuwan, S., Ching, S. M., Jinatongthai, P., Lim, K. G., Kew, S. T., & Chaiyakunapruk, N. (2019). Efficacy and safety of celecoxib on the incidence of recurrent colorectal adenomas: a systematic review and meta-analysis. Cancer Management and Research, 11, 561-571. https://doi.org/10.2147/CMAR.S180261
  24. (2016). Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: Recommendations From the U.S. Preventive Services Task Force. Annals of Internal Medicine, 164(12), 1-22. https://doi.org/10.7326/P16-9015
  25. Emilsson, L., Holme, Ø., Bretthauer, M., Cook, N. R., Buring, J. E., Løberg, M., Adami, H. O., Sesso, H. D., Gaziano, M. J., & Kalager, M. (2017). Systematic review with meta-analysis: the comparative effectiveness of aspirin vs. screening for colorectal cancer prevention. Alimentary Pharmacology & Therapeutics, 45(2), 193-204. https://doi.org/10.1111/apt.13857
  26. Nan, H., Hutter, C. M., Lin, Y., Jacobs, E. J., Ulrich, C. M., White, E., Baron, J. A., Berndt, S. I., Brenner, H., Butterbach, K., Caan, B. J., Campbell, P. T., Carlson, C. S., Casey, G., Chang-Claude, J., Chanock, S. J., Cotterchio, M., Duggan, D., Figueiredo, J. C., Fuchs, C. S., … GECCO. (2015). Association of Aspirin and NSAID Use With Risk of Colorectal Cancer According to Genetic Variants. JAMA, 313(11), 1133-1142. https://doi.org/10.1001/jama.2015.1815
  27. Song, Y., Zhong, X., Gao, P., Zhou, C., Shi, J., Wu, Z., Guo, Z., & Wang, Z. (2020). Aspirin and Its Potential Preventive Role in Cancer: An Umbrella Review. Frontiers in Endocrinology, 11, Article 3. https://doi.org/10.3389/fendo.2020.00003
  28. Simon, T. G., Ma, Y., Ludvigsson, J. F., Chong, D. Q., Giovannucci, E. L., Fuchs, C. S., Meyerhardt, J. A., Corey, K. E., Chung, R. T., Zhang, X., & Chan, A. T. (2018). Association Between Aspirin Use and Risk of Hepatocellular Carcinoma. JAMA Oncology, 4(12), 1683-1690. https://doi.org/10.1001/jamaoncol.2018.4154
  29. Sun, J., Li, Y., Liu, L., Jiang, Z., & Liu, G. (2019). Aspirin use and pancreatic cancer risk: A systematic review of observational studies. Medicine, 98(51), Article e18033. https://doi.org/10.1097/MD.0000000000018033
  30. Yokoyama, K., Ishizuka, N., Uemura, N., Mizokami, Y., Hiraishi, H., Murata, M., Uchiyama, S., Teramoto, T., Shimada, K., Yamazaki, T., Oikawa, S., Sugawara, M., Ando, K., Ikeda, Y., & JPPP study group. (2018). Effects of daily aspirin on cancer incidence and mortality in the elderly Japanese. Research and Practice in Thrombosis and Haemostasis, 2(2), 274-281. https://doi.org/10.1002/rth2.12097
  31. Siegel, R. L., Miller, K. D., & Jemal, A. (2018). Cancer statistics, 2018. CA: A Cancer Journal for Clinicians, 68(1), 7-30. https://doi.org/10.3322/caac.21442
  32. Hochmuth, F., Jochem, M., & Schlattmann, P. (2016). Meta-analysis of aspirin use and risk of lung cancer shows notable results. European Journal of Cancer Prevention, 25(4), 259-268. https://doi.org/10.1097/CEJ.0000000000000176
  33. Zhang, W., Yi, L., Shen, J., Zhang, H., Luo, P., & Zhang, J. (2020). Comparison of the benefits of celecoxib combined with anticancer therapy in advanced non-small cell lung cancer: A meta-analysis. Journal of Cancer, 11(7), 1816-1827. https://doi.org/10.7150/jca.35003
  34. Yi, L., Zhang, W., Zhang, H., Shen, J., Zou, J., Luo, P., & Zhang, J. (2018). Systematic review and meta-analysis of the benefit of celecoxib in treating advanced non-small-cell lung cancer. Drug Design, Development and Therapy, 12, 2455-2466. https://doi.org/10.2147/DDDT.S169627
  35. Lu, L., Shi, L., Zeng, J., & Wen, Z. (2017). Aspirin as a potential modality for the chemoprevention of breast cancer: A dose-response meta-analysis of cohort studies from 857,831 participants. Oncotarget, 8(25), 40389-40401. https://doi.org/10.18632/oncotarget.16315
  36. Kehm, R. D., Hopper, J. L., John, E. M., Phillips, K. A., MacInnis, R. J., Dite, G. S., Milne, R. L., Liao, Y., Zeinomar, N., Knight, J. A., Southey, M. C., Vahdat, L., Kornhauser, N., Cigler, T., Chung, W. K., Giles, G. G., McLachlan, S. A., Friedlander, M. L., Weideman, P. C., Glendon, G., … Terry, M. B. (2019). Regular use of aspirin and other non-steroidal anti-inflammatory drugs and breast cancer risk for women at familial or genetic risk: a cohort study. Breast Cancer Research, 21(1), Article 52. https://doi.org/10.1186/s13058-019-1135-y
  37. Zhang, S. M., Cook, N. R., Manson, J. E., Lee, I. M., & Buring, J. E. (2008). Low-dose aspirin and breast cancer risk: results by tumour characteristics from a randomised trial. British Journal of Cancer, 98(5), 989-991. https://doi.org/10.1038/sj.bjc.6604240
  38. Coombes, R. C., Tovey, H., Kilburn, L., Mansi, J., Palmieri, C., Bartlett, J., Hicks, J., Makris, A., Evans, A., Loibl, S., Denkert, C., Murray, E., Grieve, R., Coleman, R., Schmidt, M., Klare, P., Rezai, M., Rautenberg, B., Klutinus, N. … Bliss, J. (2018). Abstract GS3-03: A phase III multicentre double blind randomised trial of celecoxib versus placebo in primary breast cancer patients (REACT - Randomised EuropeAn celecoxib trial). Abstracts: 2017 San Antonio Breast Cancer Symposium December 5-9 (Vol. 78, Issue 4, pp. GS3-03). https://doi.org/10.1158/1538-7445.sabcs17-gs3-03
  39. Busby, J., Murray, L., Mills, K., Zhang, S. D., Liberante, F., & Cardwell, C. R. (2018). A combined connectivity mapping and pharmacoepidemiology approach to identify existing medications with breast cancer causing or preventing properties. Pharmacoepidemiology & Drug Safety, 27(1), 78-86. https://doi.org/10.1002/pds.4345
  40. Zhang, D., Bai, B., Xi, Y., Wang, T., & Zhao, Y. (2016). Is aspirin use associated with a decreased risk of ovarian cancer? A systematic review and meta-analysis of observational studies with dose-response analysis. Gynecologic Oncology, 142(2), 368-377. https://doi.org/10.1016/j.ygyno.2016.04.543
  41. Hannibal, C. G., Dehlendorff, C., & Kjaer, S. K. (2018). Use of paracetamol, low-dose aspirin, or non-aspirin non-steroidal anti-inflammatory drugs and risk of ovarian borderline tumors in Denmark. Gynecologic Oncology, 151(3), 513-518. https://doi.org/10.1016/j.ygyno.2018.09.022
  42. Verdoodt, F., Dehlendorff, C., Friis, S., & Kjaer, S. K. (2018). Non-aspirin NSAID use and ovarian cancer mortality. Gynecologic Oncology, 150(2), 331-337. https://doi.org/10.1016/j.ygyno.2018.06.018
  43. Thapa, D., & Ghosh, R. (2015). Chronic inflammatory mediators enhance prostate cancer development and progression. Biochemical Pharmacology, 94(2), 53-62. https://doi.org/10.1016/j.bcp.2014.12.023
  44. Shang, Z., Wang, X., Yan, H., Cui, B., Wang, Q., Wu, J., Cui, X., Li, J., Ou, T., & Yang, K. (2018). Intake of Non-steroidal Anti-inflammatory Drugs and the Risk of Prostate Cancer: A Meta-Analysis. Frontiers in Oncology, 8, Article 437. https://doi.org/10.3389/fonc.2018.00437
  45. Hurwitz, L. M., Joshu, C. E., Barber, J. R., Prizment, A. E., Vitolins, M. Z., Jones, M. R., Folsom, A. R., Han, M., & Platz, E. A. (2019). Aspirin and Non-Aspirin NSAID Use and Prostate Cancer Incidence, Mortality, and Case Fatality in the Atherosclerosis Risk in Communities Study. Cancer Epidemiology, Biomarkers & Prevention, 28(3), 563-569. https://doi.org/10.1158/1055-9965.EPI-18-0965
  46. Zhou, J., Xia, S., Li, T., & Liu, R. (2019). Could aspirin be a lifesaver for prostate cancer patients in prostate cancer-specific mortality?: an update systematic review and meta-analysis. BMC Cancer, 19(1), Article 1186. https://doi.org/10.1186/s12885-019-6415-5
  47. Muranushi, C., Olsen, C. M., Pandeya, N., & Green, A. C. (2015). Aspirin and Nonsteroidal Anti-Inflammatory Drugs Can Prevent Cutaneous Squamous Cell Carcinoma: a Systematic Review and Meta-Analysis. Journal of Investigative Dermatology, 135(4), 975-983. https://doi.org/10.1038/jid.2014.531
  48. Ma, Y., Yu, P., Lin, S., Li, Q., Fang, Z., & Huang, Z. (2020). The association between nonsteroidal anti-inflammatory drugs and skin cancer: Different responses in American and European populations. Pharmacological Research, 152, Article 104499. https://doi.org/10.1016/j.phrs.2019.104499
  49. Johannesdottir, S. A., Chang, E. T., Mehnert, F., Schmidt, M., Olesen, A. B., & Sørensen, H. T. (2012). Nonsteroidal anti-inflammatory drugs and the risk of skin cancer: a population-based case-control study. Cancer, 118(19), 4768-4776. https://doi.org/10.1002/cncr.27406
  50. Elmets, C. A., Viner, J. L., Pentland, A. P., Cantrell, W., Lin, H. Y., Bailey, H., Kang, S., Linden, K. G., Heffernan, M., Duvic, M., Richmond, E., Elewski, B. E., Umar, A., Bell, W., & Gordon, G. B. (2010). Chemoprevention of Nonmelanoma Skin Cancer With Celecoxib: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of the National Cancer Institute, 102(24), 1835-1844. https://doi.org/10.1093/jnci/djq442

Published

2021-06-07

How to Cite

1.
Buheruk VV, Voloshyna OB, Kovalchuk LI, Balashova IV, Naidionova OV. Potential role of acetylsalicilic acid and other non-steroidal anti-inflammatory drugs in cancer risk reduction (literature review) . Zaporozhye Medical Journal [Internet]. 2021Jun.7 [cited 2026May15];23(3). Available from: https://zmj.zsmu.edu.ua/article/view/209851

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Review