In 1997, the International Agency for Research on Cancer (IARC) published an evidence-based evaluation of the association between non-steroidal anti- inflammatory drugs (NSAIDs) and cancer prevention. The purpose of this current review is to describe the nature and extent of the evidence on NSAIDs (such as aspirin) and cancer prevention since 1997. There is good evidence from observational studies that NSAIDs can lower the risk colorectal cancer by 50%. New evidence on colorectal adenomas is beginning to appear from ongoing (or recently completed) randomized trials. The evidence that NSAIDs can lower the risk of stomach and esophageal cancer is accumulating but the evidence is still limited. There is some suggestive evidence, but far from conclusive, that NSAIDs can reduce the risk of breast cancer. NSAIDs may also lower the risk of cancers in other organs including prostate and bladder; however, further studies are warranted. The epidemiological evidence that NSAIDs lower the risk of cancer is supported by biologically plausible mechanisms of action.
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