Open Access Highly Accessed Research article

The role of chemoprevention by selective cyclooxygenase-2 inhibitors in colorectal cancer patients - a population-based study

Yi-Hsin Yang12, Yea-Huei Kao Yang3*, Ching-Lan Cheng3, Pei-Shan Ho24 and Ying-Chin Ko567

Author affiliations

1 School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan

2 Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

3 Institute of Clinical Pharmacy and Pharmaceutical Sciences, Health Outcome Research Center, National Cheng Kung University, Tainan, Taiwan

4 Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

5 Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

6 Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan

7 Enviroment-Omics-Disease Reserach Center, China Medical University Hospital, Taichung, Taiwan

For all author emails, please log on.

Citation and License

BMC Cancer 2012, 12:582  doi:10.1186/1471-2407-12-582

Published: 6 December 2012



There are limited population-based studies focusing on the chemopreventive effects of selective cyclooxygenase-2 (COX-2) inhibitors against colorectal cancer. The purpose of this study is to assess the trends and dose–response effects of various medication possession ratios (MPR) of selective COX-2 inhibitor used for chemoprevention of colorectal cancer.


A population-based case–control study was conducted using the Taiwan Health Insurance Research Database (NHIRD). The study comprised 21,460 colorectal cancer patients and 79,331 controls. The conditional logistic regression was applied to estimate the odds ratios (ORs) for COX-2 inhibitors used for several durations (5 years, 3 years, 1 year, 6 months and 3 months) prior to the index date.


In patients receiving selective COX-2 inhibitors, the OR was 0.51 (95% CI=0.29~0.90, p=0.021) for an estimated 5-year period in developing colorectal cancer. ORs showing significant protection effects were found in 10% of MPRs for 5-year, 3-year, and 1-year usage. Risk reduction against colorectal cancer by selective COX-2 inhibitors was observed as early as 6 months after usage.


Our results indicate that selective COX-2 inhibitors may reduce the development of colorectal cancer by at least 10% based on the MPRs evaluated. Given the limited number of clinical reports from general populations, our results add to the knowledge of chemopreventive effects of selective COX-2 inhibitors against cancer in individuals at no increased risk of colorectal cancer.

Chemoprevention; Colorectal cancer; Selective COX-2 inhibitor; Population-based study