Aspirin Prevention of Colorectal Cancer: More or Less?
Authors: Robert S. Sandler
Journal: Annals of Internal Medicine (2004)

Editorials3 February 2004Aspirin Prevention of Colorectal Cancer: More or Less?Robert S. Sandler, MD, MPHRobert S. Sandler, MD, MPHFrom University of North Carolina, Chapel Hill, NC 27599-7555.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-3-200402030-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The concept of cancer chemoprevention is tantalizing. If we had a pill that could prevent cancer, we might escape the need for potentially disfiguring surgery or toxic chemotherapy. If the pill were familiar, cheap, and readily available, so much the better. In this issue, Chan and colleagues (1) provide additional evidence that we may actually have such an agent for colorectal cancer. Its identity? Aspirin.We first recognized that aspirin might decrease the risk for colorectal cancer more than 15 years ago (2). Since that time, a large number of retrospective and prospective studies have shown that regular aspirin users ...References1. Chan AT, Giovannucci EL, Schernhammer ES, Colditz GA, Hunter DJ, Willett WC, et al . A prospective study of aspirin use and the risk for colorectal adenoma. Ann Intern Med. 2004;140:157-66. LinkGoogle Scholar2. Kune GA, Kune S, Watson LF. Colorectal cancer risk, chronic illnesses, operations, and medications: case control results from the Melbourne Colorectal Cancer Study. Cancer Res. 1988;48:4399-404. [PMID: 3390835] MedlineGoogle Scholar3. Sandler RS. Aspirin and other nonsteroidal anti-inflammatory agents in the prevention of colorectal cancer. Important Adv Oncol. 1996;:123-37. [PMID: 8791132] MedlineGoogle Scholar4. Shaheen NJ, Straus WL, Sandler RS. Chemoprevention of gastrointestinal malignancies with nonsteroidal antiinflammatory drugs. Cancer. 2002;94:950-63. [PMID: 11920463] CrossrefMedlineGoogle Scholar5. Benamouzig R, Deyra J, Martin A, Girard B, Jullian E, Piednoir B, et al . Daily soluble aspirin and prevention of colorectal adenoma recurrence: one-year results of the APACC trial. Gastroenterology. 2003;125:328-36. [PMID: 12891533] CrossrefMedlineGoogle Scholar6. Baron JA, Cole BF, Sandler RS, Haile RW, Ahnen D, Bresalier R, et al . A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med. 2003;348:891-9. [PMID: 12621133] CrossrefMedlineGoogle Scholar7. Sandler RS, Halabi S, Baron JA, Budinger S, Paskett E, Keresztes R, et al . A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med. 2003;348:883-90. [PMID: 12621132] CrossrefMedlineGoogle Scholar8. He J, Whelton PK, Vu B, Klag MJ. Aspirin and risk of hemorrhagic stroke: a meta-analysis of randomized, controlled trials. JAMA. 1998;280:1930-5. [PMID: 9851479] CrossrefMedlineGoogle Scholar9. Cryer B. Gastrointestinal safety of low-dose aspirin. Am J Manag Care. 2002;8:S701-8. [PMID: 12512737] MedlineGoogle Scholar10. Suleiman S, Rex DK, Sonnenberg A. Chemoprevention of colorectal cancer by aspirin: a cost-effectiveness analysis. Gastroenterology. 2002;122:78-84. [PMID: 11781283] CrossrefMedlineGoogle Scholar11. Ladabaum U, Chopra CL, Huang G, Scheiman JM, Chernew ME, Fendrick AM. Aspirin as an adjunct to screening for prevention of sporadic colorectal cancer. A cost-effectiveness analysis. Ann Intern Med. 2001;135:769-81. [PMID: 11694102] LinkGoogle Scholar12. Hayden M, Pignone M, Phillips C, Mulrow C. Aspirin for the primary prevention of cardiovascular events: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;136:161-72. [PMID: 11790072] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of North Carolina, Chapel Hill, NC 27599-7555.Disclosures:Consultancies: Merck; Grants received: Merck.Corresponding Author: Robert S. Sandler, MD, MPH, Division of Gastroenterology and Hepatology, University of North Carolina, CB#7555, 4111 Bioinformatics Building, Chapel Hill, NC 27599-7555; e-mail, [email protected]unc.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Prospective Study of Aspirin Use and the Risk for Colorectal Adenoma Andrew T. Chan , Edward L. Giovannucci , Eva S. Schernhammer , Graham A. Colditz , David J. Hunter , Walter C. Willett , and Charles S. Fuchs Metrics Cited bySerum Salicylate Levels and Risk of Recurrent Colorectal AdenomasREDUCTION OF ULCERATIVE COLITIS NEOPLASIA RISK BY 5-ASANarrative Review: Screening for Colorectal Cancer in Patients with a First-Degree Relative with Colonic NeoplasiaGlenn M. Eisen, MD, MPH and David S. Weinberg, MD, MSc 3 February 2004Volume 140, Issue 3Page: 224-225KeywordsAdenomasArthritisAspirinChemopreventionColonColonoscopyColorectal cancerHemorrhageObservational studiesRandomized trials ePublished: 3 February 2004 Issue Published: 3 February 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...