Long-Term Aspirin Use Lowers CRC Risk in Lynch Syndrome

Long-term aspirin use benefits individuals with increased hereditary risk of colorectal cancer

FRIDAY, Oct. 28 (HealthDay News) -- Long-term use of aspirin reduces the risk for colorectal cancer in carriers of Lynch syndrome, according to a study published online Oct. 28 in The Lancet.

John Burn, M.D., from Newcastle University in the United Kingdom, and colleagues investigated the long-term effect of aspirin on the development of colorectal cancer in carriers of Lynch syndrome who participated in the Colorectal Adenoma/Carcinoma Prevention Program 2 trial. Participants were randomized in blocks of 16 to receive 600 mg aspirin (427 subjects) or aspirin placebo (434) for up to four years. The main study end point was the development of colorectal cancer. Analysis was carried out on an intention-to-treat basis and per protocol basis.

The investigators found that, at the mean follow-up of 55.7 months, 53 cases of primary colorectal cancer were reported in 48 participants, including 18 assigned to aspirin and 30 assigned to aspirin placebo. The time to first colorectal cancer showed a hazard ratio (HR) of 0.63 (P = 0.12) in the intention-to-treat analysis. Taking multiple primary events into account, Poisson regression gave an incidence rate ratio (IRR) of 0.56. Among participants taking aspirin or aspirin placebo for two years or more (258 and 250, respectively), the HR was 0.41 and the IRR was 0.37, on per-protocol analysis. Data for post-intervention adverse events were unavailable; adverse events did not differ between the groups during the intervention.

"Our results, taken in conjunction with recent research, provide a basis for recommendation of aspirin chemoprevention in Lynch syndrome as standard of care," the authors write.

One of the study authors disclosed financial ties to Bayer; the study was partially funded by the Bayer Corporation and Bayer Pharma.

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