Chemoprevention Study Of Experimental Barrett's Esophagus With Selective Cyclooxygenase-2 Inhibitor

Background: Before the mid 1970s, the incidence of adenocarcinoma of the esophagus seems to have represented less than 5% of all esophageal cancers. Thereafter, the incidence of adenocarcinoma of the esophagus has increased rapidly in the United States and in large parts of Europe, and is still rising.The reported increase amone ranged from 1.5 to 17% per year in these studies. The strongest risk condition for esophageal adenocarcinoma is Barrett's esophagus. Barrett's esophagus is an acquired condition secondary to long standing gastroesophageal reflux disease. A majority of cases with adenocarcinoma of the esophagus arise from a Barrett's mucosa. In studies with a large sample size, the excess risk has been estimated to be 30-to 40-fold relative to the risk of the general population. The first epidemiological study exhibiting approximately 50% reduced risk of large bowel cancer with aspirin came in 1991. Another case-control study compared 514 patients with esophageal cancer, 629 with gastric cancer, and 695 control to establish a possible risk reduction in esophageal and gastric cancer with aspirin use. Results showed that aspirin use decreased the risk of esophageal adenocarcinoma, esophageal squamous cell carcinoma, and gastric adenocarcinoma. Studies shown that reduce risk of cancer by aspirin and other NSAEDs through inhibition of COX-2 activity. COX-2 over-expression has been demonstrated in carcinomas of the esophageal adenoarcinoma, There is evidence shown that selective COX-2 inhibitors...