The existing epidemiologic literature was comprehensively reviewed to retrieve all epidemiologic studies (case control and cohort studies) that examined exposure to traditional over the counter nonsteroidal anti-inflammatory drugs (OTC NSAIDs) and the risk of cancers of the colon, breast, prostate and lung from 1980 forward. These malignancies account for more that half of all cancer deaths in the United States and the United Kingdom. Estimates of effects (relative risks or odds ratios) and 95% confidence intervals were abstracted from these reports for meta-analysis. Regular intake of OTC NSAIDs produced highly significant composite risk reductions of 43% for colon cancer, 25% for breast cancer, 28% for lung cancer, and 27% for prostate cancer. Furthermore, in a series of case control studies, daily use of a selective COX-2 inhibitor, either celecoxib or rofecoxib, significantly reduced the risk for each of these malignancies. The evidence is compelling that anti-inflammatory agents with selective or non-selective activity against cycloooxygenase- 2 (COX-2) have strong potential for the chemoprevention of cancers of the colon, breast, prostate and lung. Results confirming that COX-2 blockade is effective for cancer prevention have been tempered by observations that some selective COX-2 inhibitors pose a risk to the cardiovascular system. Nevertheless, meta-analysis of independent estimates from 72 studies provides no evidence that the selective COX-2 inhibitor, celecoxib, influences the relative risk of cardiovascular disease (composite relative risk = 0.98, 95% CI = 0.88–1.10). Molecular studies reveal that over-expression of COX-2 is a prominent feature of premalignant and malignant neoplasms. Evidence is accumulating that carcinogenesis often evolves as a progressive series of highly specific cellular and molecular changes in response to induction of constitutive over-expression of COX-2 and the prostaglandin cascade in the “inflammogenesis of cancer”.

中文翻译：

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在结肠癌，乳腺癌，前列腺癌和肺癌的化学预防中，环氧合酶2（cox-2）的阻断。

对现有的流行病学文献进行了全面审查，以检索所有流行病学研究（病例对照研究和队列研究），这些研究检查了非处方类固醇消炎药（OTC NSAIDs）的传统暴露以及结肠癌，乳腺癌，前列腺癌和肺癌的风险从1980年开始。在美国和英国，这些恶性肿瘤占所有癌症死亡人数的一半以上。从这些报告中提取了影响（相对风险或优势比）和95％置信区间的估计值，以进行荟萃分析。定期服用OTC NSAIDs可使结肠癌的复合风险显着降低，分别为43％，乳腺癌25％，肺癌28％和前列腺癌27％。此外，在一系列病例对照研究中，每天使用选择性COX-2抑制剂，塞来昔布或罗非昔布显着降低了这些恶性肿瘤的风险。令人信服的证据表明，具有针对环氧合酶2（COX-2）的选择性或非选择性活性的抗炎药具有化学预防结肠癌，乳腺癌，前列腺癌和肺癌的强大潜力。通过观察某些选择性COX-2抑制剂对心血管系统构成风险的观察，证实了COX-2阻断剂对癌症预防有效的结果。然而，来自72项研究的独立估计的荟萃分析没有提供证据表明选择性COX-2抑制剂塞来昔布会影响心血管疾病的相对风险（综合相对风险= 0.98，95％CI = 0.88–1.10）。分子研究表明，COX-2的过度表达是恶变前和恶性肿瘤的显着特征。越来越多的证据表明，在“癌症的炎症发生”中，响应于COX-2组成性过表达的诱导和前列腺素级联反应，致癌作用通常会随着一系列高度特异性的细胞和分子变化而发展。