Literature DB >> 12621132

A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer.

Robert S Sandler1, Susan Halabi, John A Baron, Susan Budinger, Electra Paskett, Roger Keresztes, Nicholas Petrelli, J Marc Pipas, Daniel D Karp, Charles L Loprinzi, Gideon Steinbach, Richard Schilsky.   

Abstract

BACKGROUND: Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers.
METHODS: We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas. We randomly assigned 635 patients with previous colorectal cancer to receive either 325 mg of aspirin per day or placebo. We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations. Relative risks were adjusted for age, sex, cancer stage, the number of colonoscopic examinations, and the time to a first colonoscopy. The study was terminated early by an independent data and safety monitoring board when statistically significant results were reported during a planned interim analysis.
RESULTS: A total of 517 randomized patients had at least one colonoscopic examination a median of 12.8 months after randomization. One or more adenomas were found in 17 percent of patients in the aspirin group and 27 percent of patients in the placebo group (P=0.004). The mean (+/-SD) number of adenomas was lower in the aspirin group than the placebo group (0.30+/-0.87 vs. 0.49+/-0.99, P=0.003 by the Wilcoxon test). The adjusted relative risk of any recurrent adenoma in the aspirin group, as compared with the placebo group, was 0.65 (95 percent confidence interval, 0.46 to 0.91). The time to the detection of a first adenoma was longer in the aspirin group than in the placebo group (hazard ratio for the detection of a new polyp, 0.64; 95 percent confidence interval, 0.43 to 0.94; P=0.022).
CONCLUSIONS: Daily use of aspirin is associated with a significant reduction in the incidence of colorectal adenomas in patients with previous colorectal cancer. Copyright 2003 Massachusetts Medical Society

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Year:  2003        PMID: 12621132     DOI: 10.1056/NEJMoa021633

Source DB:  PubMed          Journal:  N Engl J Med        ISSN: 0028-4793            Impact factor:   91.245


  337 in total

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2.  [Acetylsalicylic acid for prevention of colorectal adenomas. The APP Study].

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Authors:  Xiaoyun Liao; Paul Lochhead; Reiko Nishihara; Teppei Morikawa; Aya Kuchiba; Mai Yamauchi; Yu Imamura; Zhi Rong Qian; Yoshifumi Baba; Kaori Shima; Ruifang Sun; Katsuhiko Nosho; Jeffrey A Meyerhardt; Edward Giovannucci; Charles S Fuchs; Andrew T Chan; Shuji Ogino
Journal:  N Engl J Med       Date:  2012-10-25       Impact factor: 91.245

9.  Inhibition of apoptosis in normal and transformed intestinal epithelial cells by cAMP through induction of inhibitor of apoptosis protein (IAP)-2.

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