Review article: cyclooxygenase – a target for colon cancer prevention

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Abstract
Use of nonsteroidal anti‐inflammatory drugs such as aspirin, which are known to inhibit cyclooxygenase activity, reduces the relative risk of colorectal cancer in humans by 40–50%. Animal and human studies have shown a 50–80% reduction in tumour multiplicity following treatment with a variety of nonsteroidal anti‐inflammatory drugs. Two isoforms of cyclooxygenase have been described, cyclooxygenase‐1 (COX‐1) and cyclooxygenase‐2 (COX‐2). In 85% of colorectal adenocarcinomas taken from humans, COX‐2 levels are 2–50‐fold higher than levels in adjacent normal intestinal mucosa, while COX‐1 levels are unchanged. These observations raise the question: Does COX‐1 or COX‐2 provide a useful target for prevention or treatment of colorectal cancer?