Prevent Colon Cancer With Daily Aspirin?
03-12-2003 04:01 AM
Prevent Colon Cancer With Daily Aspirin?
Can daily aspirin prevent colon cancer?
Studies: Disease risk lowered, but deadly side effects remain
Wednesday, March 5, 2003 Posted: 6:03 PM EST (2303 GMT)
BOSTON (Reuters) -- Popping a daily aspirin may help prevent the development of colon cancer, the second leading cause of cancer deaths in the United States, researchers said Wednesday.
But two studies published in the New England Journal of Medicine do not resolve the issue of whether aspirin can prevent colon tumors in everyone, or whether the benefits of taking aspirin are great enough to warrant risking the sometimes deadly side effects of internal bleeding and stroke.
"Although aspirin may be of some benefit in preventing colorectal cancer, it cannot yet be recommended for this indication and is not a substitute for screening and surveillance," Dr. Thomas Imperiale of the Indiana University School of Medicine wrote in a commentary.
The first study, of 635 volunteers who had won one battle against colorectal cancer, found that among those who took a 325-mg aspirin daily 36 percent fewer people developed new growths, sometimes known as polyps. And when polyps did appear in the colon, there tended to be fewer of them.
The study was halted early because the results were so decisive. Polyps themselves are not cancerous, but some polyp cells can mutate into tumors.
"It provides a new way to lower the risk of recurrence in patients who have had colon cancer," said Dr. Richard Schilsky of the University of Chicago, who worked on the study.
The study did not look at actual cases of cancer because colon tumors can take a long time to develop. But the researchers believe that reducing the number of polyps will cut the risk of colorectal cancer.
The larger study, led by Dr. John Baron of the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, involved patients who had had polyps removed but had not developed cancer.
After about three years, the researchers found new polyps or cancer in 12.9 percent of the 372 of the patients who got placebo pills compared to 7.7 percent of the 377 people taking an 81-mg baby aspirin tablet daily.
To the surprise of the researchers, the 372 people taking a full-sized aspirin tablet each day -- 325 mg -- did not have a statistically significant reduction in risk -- 10.7 percent of them developed polyps or tumors.
"The difference in the two studies could be that we enrolled higher-risk patients, or it could simply be due to chance," the Schilsky team wrote in their report.
Imperiale said aspirin, given its side effects, is not as effective as established screening methods, such as a colonoscopy, for preventing death from colon cancer.
He said at least 471 people would have to take aspirin for at least five years to prevent one case of colorectal cancer, and 1,250 people would have to be on an aspirin regimen for at least 10 years to prevent one death from colorectal cancer.
Meanwhile, for every person who is spared colon cancer there would be one person who suffered from major bleeding as a result of the aspirin therapy, and more people would suffer a stroke than be spared death from colorectal cancer, according to Imperiale.
Colorectal cancer kills about 57,100 Americans each year.
03-13-2003 04:31 PM
I would never recommend taking aspirin daily, your just asking for ulcers
03-13-2003 04:37 PM
I wouldnt say that, risk for an ulcer based upon ingestion of NSAIDS is dependant upon many factores, age, food intake, etc. This article explains that only 15-30% of people ingesting NSAIDS on a regular basis experience of GI symptoms, including ulcers. Originally posted by MassMachine I would never recommend taking aspirin daily, your just asking for ulcers
The gastrointestinal effects of nonselective NSAIDs and COX-2-selective inhibitors.
Keck School of Medicine, University of Southern California, Los Angeles, CA., Loren A. Laine, MD: Professor of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin, are among the most frequently prescribed medications worldwide. The main factor limiting use of NSAIDs is concern about their gastrointestinal (GI) side effects. The purpose of this article is to review the incidence, pathophysiology, and risk factors of GI side effects associated with NSAID therapy. Upper GI symptoms, such as dyspepsia, occur in 15% to 60% of NSAID users, twice as often as in individuals not taking NSAIDs. The prevalence of gastric or duodenal ulcers in patients taking NSAIDs regularly is approximately 15% to 30%. The annual incidence of NSAID-related clinical upper GI events (complicated and symptomatic ulcers) is approximately 2.5% to 4.5%, with the annual incidence of serious complications (severe bleeding, perforation, and obstruction) about 1% to 1.5%. A history of ulcer or GI complications, advanced age, concomitant anticoagulation therapy or corticosteroid use, and high-dose or multiple NSAID therapy are associated with an increased risk of GI events during NSAID therapy.The cyclooxygenase (COX)-2 specific inhibitors (coxibs) have been developed in order to improve the GI safety and tolerability profile of therapy with NSAIDs. In numerous clinical trials, coxibs have been shown to have efficacy similar to that of nonselective NSAIDs, but are associated with significantly fewer endoscopic ulcers. In addition, 2 large outcome trials indicated that coxibs can also reduce the incidence of clinically important GI events. Semin Arthritis Rheum 32(Suppl 1):25-32. Copyright 2002, Elsevier Science (USA). All rights reserved.
03-13-2003 04:45 PM
you can pretty much guarantee as well that those people, of which as the article states only 15-30% actually experience ulcer issues, do not adhere to the strict nutritional, physical, and supplementary regimen that bb'ers do, am I right?
03-13-2003 04:50 PM
You are correct. I would assume but not 100% sure as it doesnt say. Originally posted by Biggin you can pretty much guarantee as well that those people, of which as the article states only 15-30% actually experience ulcer issues, do not adhere to the strict nutritional, physical, and supplementary regimen that bb'ers do, am I right?
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