Evidence map›Paper›PMID 40394866›Full record

ReviewCancer control : journal of the Moffitt Cancer Center

Review of Network Meta-Analyses on the Efficacy of Chemopreventive Agents on Colorectal Adenomas and Cancer.

Yibing Ruan, Chantelle Carbonell, Karen Brown, Robert J Hilsden, Darren R Brenner

Abstract readReview
In one paragraph

Review in Cancer control : journal of the Moffitt Cancer Center. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yibing RuanDepartment of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Chantelle CarbonellDepartment of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.ORCID 0009-0004-6384-3424
Karen BrownLeicester Cancer Research Centre, University of Leicester, Leicester, UK.
Robert J HilsdenDepartment of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Darren R BrennerDepartment of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BackgroundColorectal cancer (CRC) is the third most diagnosed cancer and the second leading cause of cancer-related death worldwide. Colorectal adenomas (CRAs) are a crucial precursor for CRC and a target for preventive strategies. Recent network meta-analyses (NMAs) of randomized controlled trials (RCTs) suggest that chemopreventive agents (CPAs) are associated with reductions in CRC incidence. However, the quality of this evidence is low due to significant variability in the methods and types of studies assessed.PurposeOur study reviewed the efficacy and safety of CPAs on CRAs or CRCs evaluated in NMAs of RCTs and assessed the quality of all published NMAs on CPAs.Research DesignWe searched PubMed, Embase, and Cochrane Library for studies published from inception to July 29, 2024. We included all NMAs assessing the efficacy and safety of CPAs on CRC in both average-risk (general population) and high-risk (previous history of adenoma/CRC) populations. ResultsNine NMAs comparing 15 different interventions were included. Aspirin and non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) such as celecoxib were the most studied. Aspirin demonstrated efficacy against the development of any CRA and low-dose aspirin was consistently more protective than high-dose aspirin. However, the effect of aspirin against advanced CRA was not statistically significant. Concerns for long-term aspirin use included an increased risk of gastrointestinal bleeding and ulceration, but when evaluating all serious adverse events (SAEs), aspirin users did not have an increased risk compared to controls. Non-aspirin NSAIDs showed better efficacy against advanced CRA. However, the use of non-aspirin NSAIDs such as celecoxib was associated with significantly increased risk of SAEs, particularly cardiovascular disease events.ConclusionsConsidering the balance of efficacy and safety, low-dose aspirin is currently the best option for chemoprevention of CRA/CRC. Future research is needed to better characterize the patient subgroups that benefit most and to develop new, more effective CPAs.

Indexed as

AdenomaAnticarcinogenic AgentsChemopreventionColorectal NeoplasmsAnti-Inflammatory Agents, Non-SteroidalHumansNetwork Meta-Analysis as TopicRandomized Controlled Trials as TopicAnticarcinogenic AgentsAnti-Inflammatory Agents, Non-Steroidalchemopreventionchemopreventive agentscolorectal adenomacolorectal cancerpreventive therapytherapeutic prevention

Identifiers

PMID40394866
PMCPMC12093012

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.