Inflammation and Cancer: 1006 results

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Inflammation and Cancer: An Epidemiological Perspective

Chapter Authors: J. Thun, S. Jane Henley, Ted Gansler

Series: Novartis Foundation Symposia

Summary

Many chronic inflammatory conditions increase the risk of cancer in affected

tissues. Clinical conditions that involve both inflammation and increased cancer

risk include a broad range of

immunological disorders, infections (bacterial, helminthic, viral), and chronic

chemical and mechanical irritation. For example, the inflammatory bowel

diseases, ulcerative colitis and Crohn's

disease, predispose to the development of cancers of the large bowel and/or

terminal ileum; chronic infection with the bacterium Helicobacter pylori causes

atrophic gastritis, dysplasia,

adenocarcinoma and an unusual form of gastric lymphoma; and parasitic infection

with schistosomes and other trematodes cause cancers of the urinary bladder and

the intrahepatic and extrahepatic

biliary tract. Chronic reflux of gastric acid and bile into the distal

oesophagus causes chemical injury, Barrett's oesophagus and oesophageal

adenocarcinoma. Chronic cholecystitis and gallstones

predispose to cancer of the gallbladder. Besides these clinical syndromes,

subclinical inflammation may promote the development of certain tumours. The

expression of COX-2 and lipid mediators of

inflammation increases during the multistage progression of these tumours.

Non-steroidal anti-inflammatory drugs (NSAIDs), which inhibit COX-2 activity and

tumour development in many experimental

and clinical settings, are inversely associated with certain cancers in

epidemiological studies. Despite their promise, however, anti-inflammatory drugs

are not yet recommended for the prevention or

treatment of any cancers. Numerous questions must be resolved concerning their

molecular and cellular targets of action, efficacy, safety, treatment regimen,

indications, and the balance of risks

and benefits from treatment in designated patient populations.

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