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DOI: 10.1055/s-2004-820065
© Georg Thieme Verlag Stuttgart · New York
Acetylsalicylsäure - ein geeignetes Mittel zur Krebsprävention?
Aspirin use for cancer prevention?Publication History
eingereicht: 18.11.2003
akzeptiert: 15.1.2004
Publication Date:
17 February 2004 (online)

Acetylsalicylsäure (ASS, Aspirin® u. a.) ist ein Vertreter der NSAID („nonsteroidal antiinflammatory drugs“). (Die gelegentlich anzutreffende Unterscheidung zwischen ASS und NSAID ist irreführend. Der Begriff NSAID bezeichnet in Abgrenzung zu Opioid-Analgetika und Glucocorticoid-Antiphlogistika eine Gruppe von nichtsteroidalen Substanzen mit zumeist sauren Eigenschaften, die durch einen gemeinsamen Wirkmechanismus (Hemmung der Prostaglandinsynthese) und klinisch durch analgetische, antipyretische und antiphlogistische Wirkungen charakterisiert sind. Somit ist ASS ein prototypisches NSAID.)
Neben den bekannten antiinflammatorischen, analgetischen und antipyretischen Effekten besitzt ASS eine ebenfalls gut untersuchte thrombozytenaggregationshemmende Wirkung, die klinisch zur Prävention thrombotischer vaskulärer Ereignisse, insbesondere des Myokardinfarktes, genutzt wird [1] [2]. Seit den 1980er Jahren gibt es zunehmend Hinweise auf eine protektive Wirkung von ASS in der Prävention maligner Tumorerkrankungen. Die Ergebnisse jüngster epidemiologischer [3] [4] und klinischer Studien [5] [6] haben eine intensive Diskussion zum Nutzen von ASS in der Krebsprävention angestoßen.
Literatur
- 1
Anonymous .
Collaborative meta-analysis of randomised trials of antiplatelet therapy for
prevention of death, myocardial infarction, and stroke in high risk patients.
BMJ.
2002;
324
71-86
MissingFormLabel
- 2
Hayden M, Pignone M, Phillips C, Mulrow C.
Aspirin for the primary prevention of cardiovascular events: a summary of the
evidence for the US Preventive Services Task Force.
Ann Intern Med.
2002;
136
161-172
MissingFormLabel
- 3
Garcia-Rodriguez L A, Huerta-Alvarez C.
Reduced risk of colorectal cancer amonglong-term users of aspirin and nonaspirin
nonsteroidal antiinflammatory drugs.
Epidemiology.
2001;
12
88-93
MissingFormLabel
- 4
Bosetti C, Talamini R, Franceschi S, Negri E, Garavello W, La Vecchia C.
Aspirin use and cancers of the upper aerodigestive tract.
Br J Cancer.
2003;
88
672-674
MissingFormLabel
- 5
Baron J A, Cole B F, Sandler R S, Haile R W, Ahnen D, Bresalier R, McKeown-Eyssen G, Summers R W, Rothstein R, Burke C A, Snover D C, Church T R, Allen J I, Beach M, Beck G J, Bond J H, Byers T, Greenberg E R, Mandel J S, Marcon N, Mott L A, Pearson L, Saibil F, van Stolk R U.
A randomized trial of aspirin to prevent colorectal adenomas.
N Engl J Med.
2003;
348
891-899
MissingFormLabel
- 6
Sandler R S, Halabi S, Baron J A, Budinger S, Paskett E, Keresztes R, Petrelli N, Pipas J M, Karp D D, Loprinzi C L, Steinbach G, Schilsky R.
A randomized trial of aspirin to prevent colorectal adenomas in patients with
previous colorectal cancer.
N Engl J Med.
2003;
348
883-890
MissingFormLabel
- 7
Vane J R.
Inhibition of prostaglandin synthesis as a mechanism of action for aspirinlike
drugs.
Nat New Bio.
1971;
231
232-235
MissingFormLabel
- 8
Thun M J, Henley S J, Patrono C.
Nonsteroidal anti-inflammatory drugs as anticancer agents: mechanistic, pharmacologic,
and clinical issues.
J Natl Cancer Inst.
2002;
94
252-266
MissingFormLabel
- 9
Chan T A.
Nonsteroidal anti-inflammatory drugs, apoptosis, and colon-cancer chemoprevention.
Lancet Oncol.
2002;
3
166-174
MissingFormLabel
- 10
Eberhart C E, Coffey R J, Radhika A, Giardiello F M, Ferrenbach S, DuBois R N.
Up-regulation of cyclooxygenase 2 gene expression in human colorectal adenomas
and adenocarcinomas.
Gastroenterology.
1994;
107
1183-1188
MissingFormLabel
- 11
Ermert L, Dierkes C, Ermert M.
Immunohistochemical expression of cyclooxygenase isoenzymes and downstream enzymes
in human lung tumors.
Clin Cancer Res.
2003;
9
1604-1610
MissingFormLabel
- 12
Anderson W F, Umar A, Viner J L, Hawk E T.
The role of cyclooxygenase inhibitors in cancer prevention.
Curr Pharm Des.
2002;
8
1035-1062
MissingFormLabel
- 13
Sheehan K M, Sheahan K, O’Donoghue D P, MacSweeney F, Conroy R M, Fitzgerald D J, Murray F E.
The relationship between cyclooxygenase-2 expression and colorectal cancer.
Jama.
1999;
282
1254-1257
MissingFormLabel
- 14
Steinbach G, Lynch P M, Phillips R K, Wallace M H, Hawk E, Gordon G B, Wakabayashi N, Saunders B, Shen Y, Fujimura T, Su L K, Levin B.
The effect of celecoxib, a cyclooxygenase-2 inhibitor, in familial adenomatous
polyposis.
N Engl J Med.
2000;
342
1946-1952
MissingFormLabel
- 15
Sheng H, Shao J, Washington M K, DuBois R N.
Prostaglandin E2 increases growth and motility of colorectal carcinoma cells.
J Biol Chem.
2001;
276
18075-18081
MissingFormLabel
- 16
Gupta R A, Tan J, Krause W F, Geraci M W, Willson T M, Dey S K, DuBois R N.
Prostacyclin-mediated activation of peroxisome proliferator-activated receptor
delta in colorectal cancer.
Proc Natl Acad Sci USA.
2000;
97
13275-13280
MissingFormLabel
- 17
Tsujii M, Kawano S, Tsuji S, Sawaoka H, Hori M, DuBois R N.
Cyclooxygenase regulates angiogenesis induced by colon cancer cells.
Cell.
1998;
93
705-716
MissingFormLabel
- 18
Chan T A, Morin P J, Vogelstein B, Kinzler K W.
Mechanisms underlying nonsteroidal antiinflammatory drug-mediated apoptosis.
Proc Natl Acad Sci USA.
1998;
95
681-686
MissingFormLabel
- 19
Hannun Y A.
Functions of ceramide in coordinating cellular responses to stress.
Science.
1996;
274
1855-1859
MissingFormLabel
- 20
Scorrano L, Penzo D, Petronilli V, Pagano F, Bernardi P.
Arachidonic acid causes cell death through the mitochondrial permeability transition.
Implications for tumor necrosis factor-alpha aopototic signaling.
J Biol Chem.
2001;
276
12 035-12 040
MissingFormLabel
- 21
Thun M J, Namboodiri M M, Heath C W.
Aspirin use and reduced risk of fatal colon cancer.
N Engl J Med.
1991;
325
1593-1596
MissingFormLabel
- 22
Giovannucci E, Egan K M, Hunter D J, Stampfer M J, Colditz G A, Willett W C, Speizer F E.
Aspirin and the risk of colorectal cancer in women.
N Engl J Med.
1995;
333
609-614
MissingFormLabel
- 23
Meade E A, Smith W L, DeWitt D L.
Differential inhibition of prostaglandin endoperoxide synthase (cyclooxygenase)
isozymes by aspirin and other non-steroidal anti-inflammatory drugs.
J Biol Chem.
1993;
268
6610-6614
MissingFormLabel
- 24
Patrono C, Patrignani P, Garcia Rodriguez L A.
Cyclooxygenase-selective inhibition of prostanoid formation: transducing biochemical
selectivity into clinical read-outs.
J Clin Invest.
2001;
108
7-13
MissingFormLabel
- 25
Xu X M, Sansores-Garcia L, Chen X M, Matijevic-Aleksic N, Du M, Wu K K.
Suppression of inducible cyclooxygenase 2 gene transcription by aspirin and
sodium salicylate.
Proc Natl Acad Sci USA.
1999;
96
5292-5297
MissingFormLabel
- 26
Wu J, Xia H H, Tu S P, Fan D M, Lin M C, Kung H F, Lam S K, Wong B C.
15-Lipoxygenase-1 mediates cyclooxygenase-2 inhibitor-induced apoptosis in gastric
cancer.
Carcinogenesis.
2003;
24
243-247
MissingFormLabel
- 27
Grilli M, Pizzi M, Memo M, Spano P.
Neuroprotection by aspirin and sodium salicylate through blockade of NF-kappaB
activation.
Science.
1996;
274
1383-1385
MissingFormLabel
- 28
He T C, Chan T A, Vogelstein B, Kinzler K W.
PPARdelta is an APC-regulated target of nonsteroidal anti-inflammatory drugs.
Cell.
1999;
99
335-345
MissingFormLabel
- 29
Huls G, Koornstra J J, Kleibeuker J H.
Non-steroidal anti-inflammatory drugs and molecular carcinogenesis of colorectal
carcinomas.
Lancet.
2003;
362
230-232
MissingFormLabel
- 30
Dihlmann S, Klein S, Doeberitz M K.
Reduction of beta-Catenin/T-Cell Transcription Factor Signaling by Aspirin and
Indomethacin Is Caused by an Increased Stabilization of Phosphorylated beta-Catenin.
Mol Cancer Ther.
2003;
2
509-516
MissingFormLabel
- 31
Awtry E H, Loscalzo J.
Aspirin.
Circulation.
2000;
101
1206-1218
MissingFormLabel
- 32
Amann R, Peskar B A.
Anti-inflammatory effects of aspirin and sodium salicylate.
Eur J Pharmacol.
2002;
447
1-9
MissingFormLabel
- 33
Pinczowski D, Ekbom A, Baron J, Yuen J, Adami H O.
Risk factors for colorectal cancer in patients with ulcerative colitis: a case-control
study.
Gastroenterology.
1994;
107
117-120
MissingFormLabel
- 34
Moody G A, Jayanthi V, Probert C S, MacKay H, Mayberry J F.
Long-term therapy with sulphasalazine protects against colorectal cancer in
ulcerative colitis: a retrospective study of colorectal cancer risk and compliance
with treatment in Leicestershire.
Eur J Gastroenterol Hepatol.
1996;
8
1179-1183
MissingFormLabel
- 35
Reinacher-Schick A, Schoeneck A, Graeven U, Schwarte-Waldhoff I, Schmiegel W.
Mesalazine causes a mitotic arrest and induces caspase-dependent apoptosis in
colon carcinoma cells.
Carcinogenesis.
2003;
24
443-451
MissingFormLabel
- 36
Allgayer H.
Review article: mechanisms of action of mesalazine in preventing colorectal
carcinoma in inflammatory bowel disease.
Aliment Pharmacol Ther.
2003;
18
10-14
(Suppl 2)
MissingFormLabel
- 37
Bus P J, Nagtegaal I D, Verspaget H W, Lamers C B, Geldof H, Van Krieken J H, Griffioen G.
Mesalazine-induced apoptosis of colorectal cancer: on the verge of a new chemopreventive
era?.
Aliment Pharmacol Ther.
1999;
13
1397-1402
MissingFormLabel
- 38
Levin B.
Potential pitfalls in the use of surrogate endpoints in colorectal adenoma chemoprevention.
J Natl Cancer Inst.
2003;
95
697-699
MissingFormLabel
- 39
Levi F, Lucchini F, Negri E, La Vecchia C.
Worldwide patterns of cancer mortality 1990 - 94.
Eur J Cancer Prev.
1999;
8
381-400
MissingFormLabel
- 40
Steering Committee of the Physicians’ Health Study Research Group .
Final report on the aspirin component of the ongoing Physicians’ Health Study.
N Engl J Med.
1989;
321
129-135
MissingFormLabel
- 41
Imperiale T F.
Aspirin and the prevention of colorectal cancer.
N Engl J Med.
2003;
348
879-880
MissingFormLabel
- 42
Suleiman S, Rex D K, Sonnenberg A.
Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis.
Gastroenterology.
2002;
122
78-84
MissingFormLabel
- 43
Subbaramaiah K, Hart J C, Norton L, Dannenberg A J.
Microtubule-interfering agents stimulate the transcription of cyclooxygenase-2.
Evidence for involvement of ERK1/2 AND p38 mitogen-activated protein kinase
pathways.
J Biol Chem.
2000;
275
14 838-14 845
MissingFormLabel
- 44
Kune G A, Kune S, Watson L F.
Colorectal cancer risk, chronic illnesses, operations, and medications: case
control results from the Melbourne Colorectal Cancer Study.
Cancer Res.
1988;
48
4399-4404
MissingFormLabel
- 45
Rosenberg L, Palmer J R, Zauber A G, Warshauer M E, Stolley P D, Shapiro S.
A hypothesis: nonsteroidal anti-inflammatory drugs reduce the incidence of largebowel
cancer.
J Natl Cancer Inst.
1991;
83
355-358
MissingFormLabel
- 46
Suh O, Mettlin C, Petrelli N J.
Aspirin use, cancer, and polyps of the large bowel.
Cancer.
1993;
72
1171-1177
MissingFormLabel
- 47
Muscat J E, Stellman S D, Wynder E L.
Nonsteroidal antiinflammatory drugs and colorectal cancer.
Cancer.
1994;
74
1847-1854
MissingFormLabel
- 48
Peleg I I, Maibach H T, Brown S H, Wilcox C M.
Aspirin and nonsteroidal antiinflammatory drug use and the risk of subsequent
colorectal cancer.
Arch Intern Med.
1994;
154
394-399
MissingFormLabel
- 49
Reeves M J, Newcomb P A, Trentham-Dietz A, Storer B E, Remington P L.
Nonsteroidal anti-inflammatory drug use and protection against colorectal cancer
in women.
Cancer Epidemiol Biomarkers Prev.
1996;
5
955-960
MissingFormLabel
- 50
La Vecchia C, Negri E, Franceschi S, Conti E, Montella M, Giacosa A, Falcini A, Decarli A.
Aspirin and colorectal cancer.
Br J Cancer.
1997;
76
675-677
MissingFormLabel
- 51
Rosenberg L, Louik C, Shapiro S.
Nonsteroidal antiinflammatory drug use and reduced risk of large bowel carcinoma.
Cancer.
1998;
82
2326-2333
MissingFormLabel
- 52
Friedman G D, Coates A O, Potter J D, Slattery M L.
Drugs and colon cancer.
Pharmacoepidemiol Drug Safety.
1998;
7
99-106
MissingFormLabel
- 53
Neugut A I, Rosenberg D J, Ahsan H, Jacobson J S, Wahid N, Hagan M, Rahman M I, Khan Z R, Chen L, Pablos-Mendez A, Shea S.
Association between coronary heart disease and cancers of the breast, prostate,
and colon.
Cancer Epidemiol Biomarkers Prev.
1998;
7
869-873
MissingFormLabel
- 54
Paganini-Hill A, Chao A, Ross R K, Henderson B E.
Aspirin use and chronic diseases: a cohort study of the elderly.
Bmj.
1989;
299
1247-1250
MissingFormLabel
- 55
Thun M J, Namboodiri M M, Calle E E, Flanders W D, Heath C W.
Aspirin use and risk of fatal cancer.
Cancer Res.
1993;
53
1322-1327
MissingFormLabel
- 56
Schreinemachers D M, Everson R B.
Aspirin use and lung, colon, and breast cancer incidence in a prospective
study.
Epidemiology.
1994;
5
138-146
MissingFormLabel
- 57
Giovannucci E, Rimm E B, Stampfer M J, Colditz G A, Ascherio A, Willett W C.
Aspirin use and the risk for colorectal cancer and adenoma in male health professionals.
Ann Intern Med.
1994;
121
241-246
MissingFormLabel
- 58
Bosetti C, Gallus S, La Vecchia C.
Aspirin and cancer risk: an update to 2001.
Eur J Cancer Prev.
2002;
11
535-542
MissingFormLabel
- 59
Harris R E, Namboodiri K K, Farrar W B.
Nonsteroidal antiinflammatory drugs and breast cancer.
Epidemiology.
1996;
7
203-205
MissingFormLabel
- 60
Coogan P F, Rao S R, Rosenberg L, Palmer J R, Strom B L, Zauber A G, Stolley P D, Shapiro S.
The relationship of nonsteroidal anti-inflammatory drug use to the risk of breast
cancer.
Prev Med.
1999;
29
72-76
MissingFormLabel
- 61
Friedman G D, Ury H K.
Initial screening for carcinogenicity of commonly used drugs.
J Natl Cancer Inst.
1980;
65
723-733
MissingFormLabel
- 62
Egan K M, Stampfer M J, Giovannucci E, Rosner B A, Colditz G A.
Prospective study of regular aspirin use and the risk of breast cancer.
J Natl Cancer Inst.
1996;
88
988-993
MissingFormLabel
- 63
Harris R E, Kasbari S, Farrar W B.
Prospective study of nonsteoridal antiinflammatory drugs and breast cancer.
Oncol Rep.
1999;
6
71-73
MissingFormLabel
- 64
Tzonou A, Polychronopoulou A, Hsieh C C, Rebelakos A, Karakatsani A, Trichopoulos D.
Hair dyes, analgesics, tranquilizers and perineal talc application as risk factors
for ovarian cancer.
Int J Cancer.
1993;
55
408-410
MissingFormLabel
- 65
Cramer D W, Harlow B L, Titus-Ernstoff L, Bohlke K, Welch W R, Greenberg E R.
Over-the-counter analgesics and risk of ovarian cancer.
Lancet.
1998;
351
104-107
MissingFormLabel
- 66
Tavani A, Gallus S, La Vecchia C, Conti E, Montella M, Franceschi S.
Aspirin and ovarian cancer: an Italian case-control study.
Ann Oncol.
2000;
11
1171-1173
MissingFormLabel
- 67
Rosenberg L, Palmer J R, Rao R S, Coogan P F, Strom B L, Zauber A G, Stolley P D, Shapiro S.
A case-control study of analgesic use and ovarian cancer.
Cancer Epidemiol Biomarkers Prev.
2000;
9
933-937
MissingFormLabel
- 68
Moysich K B, Mettlin C, Piver M S, Natarajan N, Menezes R J, Swede H.
Regular use of analgesic drugs and ovarian cancer risk.
Cancer Epidemiol Biomarkers Prev.
2001;
10
903-906
MissingFormLabel
- 69
Akhmedkhanov A, Toniolo P, Zeleniuch-Jacquotte A, Kato I, Koenig K L, Shore R E.
Aspirin and epithelial ovarian cancer.
Prev Med.
2001;
33
682-687
MissingFormLabel
- 70
Leitzmann M F, Stampfer M J, Ma J, Chan J M, Colditz G A, Willett W C, Giovannucci E.
Aspirin use in relation to risk of prostate cancer.
Cancer Epidemiol Biomarkers Prev.
2002;
11
1108-1111
MissingFormLabel
- 71
Farrow D C, Vaughan T L, Hansten P D, Stanford J L, Risch H A, Gammon M D, Chow W H, Dubrow R, Ahsan H, Mayne S T, Schoenberg J B, West A B, Rotterdam H, Fraumeni J F, Blot W J.
Use of aspirin and other 10 nonsteroidal anti-inflammatory drugs and risk of
esophageal and gastric cancer.
Cancer Epidemiol Biomarkers Prev.
1998;
7
97-102
MissingFormLabel
- 72
Sharp L, Chilvers C E, Cheng K K, McKinney P A, Logan R F, Cook-Mozaffari P, Ahmed A, Day N E.
Risk factors for squamous cell carcinoma of the oesophagus in women: a case-control
study.
Br J Cancer.
2001;
85
1667-1670
MissingFormLabel
- 73
Funkhouser E M, Sharp G B.
Aspirin and reduced risk of esophageal carcinoma.
Cancer.
1995;
76
1116-1119
MissingFormLabel
- 74
Akre K, Ekstrom A M, Signorello L B, Hansson L E, Nyren O.
Aspirin and risk for gastric cancer: a population-based case-control study in
Sweden.
Br J Cancer.
2001;
84
965-968
MissingFormLabel
- 75
Anderson K E, Johnson T W, Lazovich D, Folsom A R.
Association between nonsteroidal anti-inflammatory drug use and the incidence
of pancreatic cancer.
J Natl Cancer Inst.
2002;
94
1168-1171
MissingFormLabel
Dr. Dirk Taubert
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