Ulcerative colitis and colorectal cancer: Pathogenic insights and precision strategies for prevention and treatment

Table 2 Chemopreventive drugs in colitis-associated colorectal cancer

Compound	Reported effect	Recommendation	Ref.
5-ASA	Protective effect for patients with long-standing extensive colitis. Lower risk of developing CRC/dysplasia in UC patients	Mesalamine compounds have a recognized protective role against CRC in UC patients	[99-101]
Thiopurines	Protective against HGD and CRC risk in IBD patients	No recommendations due to their carcinogenic effects (i.e., lymphoma, urinary tract cancer, non-melanoma skin cancer)	[102-104]
Biologic drugs	Chemopreventive effects of anti-TNF-α treatment in IBD patients	No recommendations	[101,105-107]
Statins and folic acid	Controversial chemopreventive role of statins on CRC in IBD patients. Protective effects of folate supplementation against CRC development	No recommendations	[108-110]
UDCA	Decrease in colonic dysplasia in patients with UC and PSC. Chemopreventive effects on risk of advanced CRC and HGD	No recommendations	[111]
NSAIDs and aspirin	No significant chemoprotective role in CRC risk	No recommendations	[112]

ASA: Aminosalicylic acid; CRC: Colorectal cancer; UC: Ulcerative colitis; IBD: Inflammatory bowel disease; HGD: High-grade dysplasia; TNF: Tumor necrosis factor; UDCA: Ursodeoxycholic acid; PSC: Primary sclerosing cholangitis; NSAIDs: Nonsteroidal anti-inflammatory drugs.