Aspirin and Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer: Weighing the Evidence
Authors: Til Stürmer, Julie E. Buring, Robert J. Glynn
Journal: Annals of Internal Medicine (2007)

Letters6 November 2007Aspirin and Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer: Weighing the EvidenceTil Stürmer, MD, MPH, Julie E. Buring, ScD, and Robert J. Glynn, PhD, ScDTil Stürmer, MD, MPHFrom Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215.Search for more papers by this author, Julie E. Buring, ScDFrom Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215.Search for more papers by this author, and Robert J. Glynn, PhD, ScDFrom Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-9-200711060-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The authors of the review papers on aspirin (1) and nonsteroidal anti-inflammatory drugs (NSAIDs) (2) for the primary prevention of colorectal cancer ignore important limitations of observational studies; raise concerns that are unlikely to be valid (1); and fail to include the analysis on NSAIDs from the Physicians' Health Study (PHS) (3), which was published in the interval covered. The authors correctly discuss shortcomings of randomized trials showing no protection in men and women—that is, low dose and short duration (1). They fail, however, to address shortcomings of observational studies on regular long-term drug use—that is, unmeasured ...References1. Dubé C, Rostom A, Lewin G, Tsertsvadze A, Barrowman N, Code C, et al. The use of aspirin for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med. 2007;146:365-75. [PMID: 17339622] LinkGoogle Scholar2. Rostom A, Dubé C, Lewin G, Tsertsvadze A, Barrowman N, Code C, et al. Nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors for primary prevention of colorectal cancer: a systematic review prepared for the U.S. Preventive Services Task Force. Ann Intern Med. 2007;146:376-89. [PMID: 17339623] LinkGoogle Scholar3. Stürmer T, Buring JE, Lee IM, Kurth T, Gaziano JM, Glynn RJ. Colorectal cancer after start of nonsteroidal anti-inflammatory drug use. Am J Med. 2006;119:494-502. [PMID: 16750963] CrossrefMedlineGoogle Scholar4. Glynn RJ, Knight EL, Levin R, Avorn J. Paradoxical relations of drug treatment with mortality in older persons. Epidemiology. 2001;12:682-9. [PMID: 11679797] CrossrefMedlineGoogle Scholar5. Stürmer T, Glynn RJ, Lee IM, Manson JE, Buring JE, Hennekens CH. Aspirin use and colorectal cancer: post-trial follow-up data from the Physicians' Health Study. Ann Intern Med. 1998;128:713-20. [PMID: 9556464] LinkGoogle Scholar6. Flossmann E, Rothwell PM. Effect of aspirin on long-term risk of colorectal cancer: consistent evidence from randomised and observational studies. Lancet. 2007;369:1603-13. [PMID: 17499602] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215.Disclosures: Dr. Stürmer receives investigator-initiated research funding and support as principal investigator from the National Institute of Aging, National Institutes of Health. Dr. Buring has received investigator-initiated research funding and support as principal investigator from the National Institutes of Health (National Heart, Lung, and Blood Institute; National Cancer Institute; and National Institute of Aging) and Dow Corning Corporation; research support for pills and/or packaging from Bayer HeathCare and the Natural Source Vitamin E Association; and honoraria from Bayer for speaking engagements. She also serves on an external scientific advisory committee for a study by Procter & Gamble. Dr. Glynn receives investigator-initiated research funding and support as principal investigator from the National Institute of Aging and the National Heart, Lung, and Blood Institute, National Institutes of Health. Drs. Stürmer and Glynn do not accept personal compensation from any pharmaceutical company, although they receive salary support from unrestricted research grants from pharmaceutical companies to the Brigham and Women's Hospital. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Use of Aspirin for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force Catherine Dubé , Alaa Rostom , Gabriela Lewin , Alexander Tsertsvadze , Nicholas Barrowman , Catherine Code , Margaret Sampson , and David Moher Nonsteroidal Anti-inflammatory Drugs and Cyclooxygenase-2 Inhibitors for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force Alaa Rostom , Catherine Dubé , Gabriela Lewin , Alexander Tsertsvadze , Nicholas Barrowman , Catherine Code , Margaret Sampson , and David Moher Aspirin and Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer: Weighing the Evidence Mary B. Barton and Marion M. Torchia Metrics 6 November 2007Volume 147, Issue 9Page: 674KeywordsAgingColorectal cancerDrugsLung and intrathoracic tumorsNSAIDsObservational studiesResearch fundingResearch quality assessment ePublished: 6 November 2007 Issue Published: 6 November 2007 CopyrightCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...