The Association Between Colorectal Cancer and Pharmaceuticals with Emphasis on Low-Dose Aspirin and Anticoagulants

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related death. Chemoprevention has been widely explored due to its potential cost-effectiveness, availability, and scalability. Aspirin is the most researched chemopreventive medication, with a substantial body of evidence supporting its survival benefits, particularly with regular long-term use and in genetically susceptible individuals with COX-2 overexpression or PIK3CA mutations. The evidence suggesting that oral anticoagulation could facilitate early CRC detection is quickly accumulating. Metformin has demonstrated improved CRC survival, most likely by reducing the diabetes-mediated risk, but it could also potentially confer direct anti-tumor effects. Corticosteroids, statins, and beta-blockers have shown mixed results, highlighting the need for further exploration. Chemoprevention remains an active research field with the potential to deliver significant clinical benefits for CRC patients, optimizing care and providing personalized prevention strategies.