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30-10-2011 | General practice | Article

Aspirin cuts colorectal cancer risk

Abstract

Lancet 2011; Advance online publication

Long-term use of aspirin significantly lowers the risk of developing colorectal cancer in patients at high risk of the disease, show study findings published in The Lancet.

Patients with Lynch syndrome, who have a genetic disposition for colorectal as well as other cancers, who took 600 mg aspirin daily for 2 years had around a 60% lower incidence of colorectal cancer than those taking placebo.

The study, the first randomised controlled trial specifically aimed at testing the chemopreventive effects of aspirin, supports previous evidence derived from cardiovascular trial data that aspirin cuts the 20-year risk of colorectal cancer and related mortality.

The case for chemoprevention using aspirin in these high-risk patients is now clear, say study authors Professor Sir John Burn (Newcastle University) and colleagues.

The trial assigned 861 participants to take 600 mg aspirin per day or placebo. Burn's team initially found no difference in colorectal cancer incidence between the two groups at an earlier 29-month follow-up.

Here, they report the long-term (mean 56 months) follow-up results, which revealed that 4% of those taking aspirin developed colorectal cancer, compared with 7% of those on placebo. Taking into account multiple primary colorectal cancers in some individuals, patients taking aspirin had a significant 44% reduced incidence of the disease.

Further analysis focusing on the 60% of patients who continued treatment for at least 2 years showed that aspirin was associated with a 63% reduced incidence of colorectal cancer.

In a related editorial, Scott Lipman (University of Texas, Houston, USA) and Andrew Chan (Harvard Medical School, Boston, Massachusetts, USA) say the results are also "invaluable" in assessing aspirin for prevention of sporadic colorectal cancer and "might at last tip the scales in favour of aspirin as the chemopreventive agent of choice for many individuals".

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Caroline Price