The role of COX-2 in intestinal inflammation and colorectal cancer

Oncogene. 2010 Feb 11;29(6):781-8. doi: 10.1038/onc.2009.421. Epub 2009 Nov 30.


Colorectal cancer (CRC) is a heterogeneous disease, including at least three major forms: hereditary, sporadic and colitis-associated CRC. A large body of evidence indicates that genetic mutations, epigenetic changes, chronic inflammation, diet and lifestyle are the risk factors for CRC. As elevated cyclooxygenase-2 (COX-2) expression was found in most CRC tissue and is associated with worse survival among CRC patients, investigators have sought to evaluate the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors (COXIBs) on CRC. The epidemiological studies, clinical trials and animal experiments indicate that NSAIDs are among the most promising chemopreventive agents for this disease. NSAIDs exert their anti-inflammatory and antitumor effects primarily by reducing prostaglandin production by inhibition of COX-2 activity. In this review, we highlight breakthroughs in our understanding of the roles of COX-2 in CRC and inflammatory bowel disease. These recent data provide a rationale for re-evaluating COX-2 as both the prognostic and the predictive marker in a wide variety of malignancies and for renewing the interest in evaluating relative benefits and risk of COXIBs in appropriately selected patients for cancer prevention and treatment.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Colorectal Neoplasms / enzymology*
  • Colorectal Neoplasms / metabolism
  • Colorectal Neoplasms / prevention & control
  • Cyclooxygenase 2 / metabolism*
  • Dinoprostone / metabolism
  • Humans
  • Inflammation / enzymology
  • Inflammation / metabolism
  • Intestinal Diseases / enzymology*
  • Intestinal Diseases / metabolism


  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2
  • Dinoprostone