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Volume 357:824-825 August 23, 2007 Number 8
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Aspirin, COX-2, and the Risk of Colorectal Cancer

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by Chan, A. T.
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To the Editor: Chan et al. (May 24 issue)1 evaluated the influence of aspirin on the risk of colorectal cancer according to the expression of cyclooxygenase-2 (COX-2) in the resected tumors and found a significantly reduced risk of colorectal cancers with overexpression of COX-2. We offer an alternative interpretation of the data.

Aspirin is an inhibitor of nuclear factor-{kappa}B,2 which in turn controls COX-2 expression3; in this way, aspirin affects COX-2 expression.4 Accordingly, among regular aspirin users, a fraction of tumors that would have shown COX-2 positivity have become negative because of the aspirin regimen. This "COX-2 shift" . . . [Full Text of this Article]



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