Sunday, October 17, 2010
aspirin colorectal cancer
Aspirin for Colorectal Cancer Protection?
Use of low-dose aspirin for 5 years was associated with significantly diminished risk for CRC.
Long-term use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduction in colorectal cancer (CRC) incidence and a reduced risk for adenomatous polyps (JW Gastroenterol Mar 28 2008). However, uncertainty remains about the dose and duration of use required for NSAIDs to provide a benefit.
To address this issue, researchers in Scotland prospectively studied aspirin use in 2279 patients with newly diagnosed CRC and 2907 matched controls from the general population. Low-dose aspirin (75 mg) was used by 15.5% of CRC patients and by 18.1% of controls.
Use of low-dose aspirin was associated with diminished risk for CRC, which was evident after 1 year and significant after 5 years (P=0.004 for trend). The effect seemed to increase until 10 years of intake and then leveled off. Taking low-dose aspirin or NSAIDs reduced relative risk for CRC by 20% to 30%; taking low-dose aspirin plus other NSAIDs reduced relative risk even further, by up to 50%. Use of NSAIDs had no effect on CRC-specific survival.
Comment: The results of this study are consistent with findings in terms of the magnitude of risk reduction and the impact of duration of aspirin therapy. They also indicate a significant protective effect even from low-dose aspirin. Previous cost analyses have suggested that the use of aspirin to prevent CRC in the general population is less cost-effective than colonoscopy because of its lower effectiveness and the substantial costs associated with gastrointestinal complications. However, patients (especially those at high risk for CRC) who take low-dose aspirin for cardiovascular protection or other reasons can expect diminished risk for CRC. Although this study did not show any benefit in survival, studies of longer duration have shown that low-dose aspirin use was associated with an overall improvement in CRC mortality. In addition, prior data have suggested that patients who had not previously been taking aspirin, and who then developed prostaglandin-producing CRCs, achieved a survival benefit from aspirin therapy that was initiated after cancer diagnosis.
— Douglas K. Rex, MD
Published in Journal Watch Gastroenterology October 15, 2010
Use of low-dose aspirin for 5 years was associated with significantly diminished risk for CRC.
Long-term use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with a reduction in colorectal cancer (CRC) incidence and a reduced risk for adenomatous polyps (JW Gastroenterol Mar 28 2008). However, uncertainty remains about the dose and duration of use required for NSAIDs to provide a benefit.
To address this issue, researchers in Scotland prospectively studied aspirin use in 2279 patients with newly diagnosed CRC and 2907 matched controls from the general population. Low-dose aspirin (75 mg) was used by 15.5% of CRC patients and by 18.1% of controls.
Use of low-dose aspirin was associated with diminished risk for CRC, which was evident after 1 year and significant after 5 years (P=0.004 for trend). The effect seemed to increase until 10 years of intake and then leveled off. Taking low-dose aspirin or NSAIDs reduced relative risk for CRC by 20% to 30%; taking low-dose aspirin plus other NSAIDs reduced relative risk even further, by up to 50%. Use of NSAIDs had no effect on CRC-specific survival.
Comment: The results of this study are consistent with findings in terms of the magnitude of risk reduction and the impact of duration of aspirin therapy. They also indicate a significant protective effect even from low-dose aspirin. Previous cost analyses have suggested that the use of aspirin to prevent CRC in the general population is less cost-effective than colonoscopy because of its lower effectiveness and the substantial costs associated with gastrointestinal complications. However, patients (especially those at high risk for CRC) who take low-dose aspirin for cardiovascular protection or other reasons can expect diminished risk for CRC. Although this study did not show any benefit in survival, studies of longer duration have shown that low-dose aspirin use was associated with an overall improvement in CRC mortality. In addition, prior data have suggested that patients who had not previously been taking aspirin, and who then developed prostaglandin-producing CRCs, achieved a survival benefit from aspirin therapy that was initiated after cancer diagnosis.
— Douglas K. Rex, MD
Published in Journal Watch Gastroenterology October 15, 2010
# posted by roodbont @ 11:37 AM 
