Population‐based case‐control study: chemoprotection of colorectal cancer with non‐aspirin nonsteroidal anti‐inflammatory drugs and other drugs for pain control

Summary Background Inflammation and overexpression of cyclooxygenase‐2 (COX‐2) have been described to play a key role in the progression from nonpathologic intestinal mucosa to colorectal cancer (CRC). Aims To assess the chemoprotective effect of non‐aspirin nonsteroidal anti‐inflammatory drugs (NA‐NSAIDs) under different patterns of use in a Mediterranean population and to explore the potential effect of symptomatic slow‐acting drugs for osteoarthritis (SYSADOAs; chondroitin sulfate and glucosamine) and metamizole (or dipyrone), also reported to influence COX‐2 activity. Methods We performed a case‐control study nested in a cohort extracted from the primary care database, BIFAP. From 2001 to 2014, we included 15 491 incident cases and 60 000 random controls. To estimate the association between the drugs of interest and CRC, we built logistic regression models to compute the adjusted‐odds ratios (AOR) and 95% confidence intervals (CI). Results NA‐NSAIDs use was associated with a reduced risk of CRC (AOR = 0.67; 95% CI: 0.63‐0.71) and increased linearly with duration of treatment (p for trend