Non-steroidal anti-inflammatory drugs, or NSAIDs, have previously been shown to reduce the incidence of polyps and cancers of the colon and rectum. This class of drugs includes the well-known medications ibuprofen, naproxen, sulindac, indomethacin, Celebrex, Vioxx, and aspirin, among others. However, enthusiasm for using NSAIDs as colorectal polyp and cancer prevention drugs has cooled significantly after several large prospective clinical research studies linked several of these drugs, including Celebrex and the subsequently discontinued Vioxx, to an increased risk of heart disease. Fortunately, aspirin, which is a weak NSAID, is still thought to protect the heart against coronary artery disease. However, previous clinical research studies have suggested that daily aspirin use only provides very modest protection, if any, against polyps and cancers of the colon and rectum. Now, a new study, just published in the Journal of the National Cancer Institute, comprehensively reviews the results of 4 prospective clinical colorectal cancer prevention research studies, and suggests that the humble aspirin pill may, indeed, offer significant protection against the type of colorectal polyps (adenomas) that are believed to give rise to virtually all colorectal cancers.
This new study performed a complex statistical evaluation, called a meta-analysis, of 4 prospective, randomized, placebo-controlled colorectal cancer prevention trials that, together, included almost 3,000 patient volunteers. The average age of these patient volunteers was 58 years, and average patient follow-up of these nearly 3,000 patients was about 3 years. Colonoscopy was performed on about 2,700 of these patients during the course of these 4 studies. Among the patients who were secretly randomized to receive placebo (sugar) pills, 37 percent were found to develop polyps (adenomas) of the colon or rectum during the course of these clinical studies. Among the patients who were secretly assigned an aspirin pill each day, 33 percent were found to harbor colorectal adenomas while being observed. Advanced precancerous adenomas were also identified in 12 percent of the patients in the placebo group, while 9 percent of the patients in the daily aspirin group were found to have advanced premalignant adenomas.
After analyzing the data, the authors of this study determined that any dose of aspirin between 81 mg and 325 mg per day was associated with a 17 percent reduction in the relative risk of colorectal adenomas, and an absolute reduction in the risk of adenomas of about 7 percent. Moreover, a daily aspirin pill was associated with a 28 percent relative reduction in the risk of developing advanced high-risk adenomas (i.e., the type of colon or rectal polyp that is most likely to subsequently progress to become a cancer).
In summary, based upon data from 4 different prospective, randomized, placebo-controlled clinical colorectal cancer prevention research studies, a daily baby aspirin, or a daily 325 mg "regular" aspirin pill, significantly reduced the incidence of colon and rectal polyps, and especially the high-risk forms of adenomatous polyps that are more likely to progress to colon and rectal cancers.
If you are not already taking aspirin, you should first consult with your physician before beginning aspirin therapy. Aspirin, like all NSAIDs, can cause ulcerations in the GI tract, as well as kidney damage, in susceptible patients. If there are no contraindications to taking aspirin in your case, however, then you may be able to reduce not only your risk of cardiovascular disease, but also your risk of colorectal cancer as well, by taking a daily aspirin tablet.
Robert A. Wascher, MD, FACS Article Source: http://EzineArticles.com/?expert=Robert_Wascher |  |
No comments:
Post a Comment