Colon cancer prevention and low-dose aspirin - Tips from Other Journals

Date: June, 1992

The only preventive strategy that has been demonstrated to reduce the incidence and mortality of colorectal cancer is adherence to a high-fiber, low-fat diet. Studies have suggested that aspirin and other non-steroidal anti-inflammatory drugs may have a protective effect. Thun and colleagues gathered information on mortality from 662,424 participants in the Cancer Prevention Study II, an ongoing, prospective mortality study.

Multivariate analysis was performed on aspirin use and colon cancer mortality in 598 patients with colon cancer and 3,058 matched control subjects. The relative risk for colon cancer mortality was 0.6 in men and women who took aspirin 16 or more times a month for at least one year. The findings were not altered after adjusting for dietary factors, physical activity, obesity, family history and conditions that might affect either aspirin use or mortality, such as cancer or heart disease.

The authors conclude that regular use of aspirin in low does may reduce the risk of death from colon cancer. Whether this is due to a direct effect of aspirin (perhaps mediated by inhibition of prostaglandin synthesis) or to other factors indirectly associated with aspirin use is unknown.

In a related editorial, Baron and Greenberg warn that caution is necessary in interpreting these results. For example, the authors did not assess whether aspirin use reduced rectal cancer mortality. Furthermore, the aspirin and nonaspirin treatment groups may not have been comparable because because of selection bias. Further clinical trials are necessary to evaluate the intriguing findings of this study. (New England Journal of Medicine, December 5, 1991, vol. 325, pp. 1593, 1644.)

COPYRIGHT 1992 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

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