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World J Gastrointest Pharmacol Ther. Feb 6, 2014; 5(1): 40-49
Published online Feb 6, 2014. doi: 10.4292/wjgpt.v5.i1.40
Published online Feb 6, 2014. doi: 10.4292/wjgpt.v5.i1.40
Table 1 Summary of the associations between regular use of aspirin and risk of colorectal cancer in case-control and cohort studies
Study type | n | Aspirin | Controls | OR (95%CI) | P value |
Case-control | |||||
Any ASA | 26 | 10464/25618 | 28300/47834 | 0.67 (0.60-0.74) | < 0.0001 |
Maximum reported ASA | 17 | 1551/12659 | 2664/18153 | 0.62 (0.58-0.67) | < 0.0001 |
ASA ≥ 5 yr | 10 | 971/7682 | 1534/10029 | 0.68 (0.63-0.75) | < 0.0001 |
Daily ASA | 4 | 165/1254 | 349/1523 | 0.49 (0.40-0.60) | < 0.0001 |
Daily ASA ≥ 5 yr | 1 | 66/1668 | 121/1973 | 0.63 (0.46-0.86) | 0.004 |
Standard cohort | |||||
Any Aspirin | 11 | 3791/2764414 | 3623/2514652 | 0.85 (0.82-0.89) | < 0.0001 |
Maximum reported ASA | 8 | 661/664475 | 1858/1374905 | 0.78 (0.71-0.84) | < 0.0001 |
ASA ≥ 5 yr | 4 | 889/1 022192 | 1311/1304760 | 0.76 (0.70–0.82) | < 0.0001 |
Daily ASA | 5 | 741/658536 | 1115/819288 | 0.80 (0.73-0.88) | < 0.0001 |
Daily ASA ≥ 5 yr | 1 | 60/38302 | 420/232116 | 0.68 (0.52-0.90) | 0.0060 |
Nested case-control | |||||
Any ASA | 6 | 2215/8926 | 65 099/109526 | 0.87 (0.75-1.00) | 0.0700 |
Maximum reported ASA | 5 | 206/4457 | 8302/40948 | 0.67 (0.58-0.77) | < 0.0001 |
ASA ≥ 5 yr | 1 | 116/228 | 23704/37935 | 0.62 (0.48-0.81) | < 0.0001 |
Daily ASA | 1 | 53/165 | 8744/22975 | 0.77 (0.55-1.07) | 0.1400 |
Daily ASA ≥ 5 yr | 1 | 29/141 | 7274/21505 | 0.51 (0.34-0.76) | 0.0120 |
Table 2 Characteristics of trials included in Rothwell et al study and details of post-trial follow-up
Thromobosis prevention trial | Swedish aspirin low dose trial | UK-TIA aspirin trial | British doctors aspirin trial | |
ASA comparison | 75 mg/d vs placebo | 75 mg/d vs placebo | 300 mg vs 1200 mg/d vs placebo | 500 mg/d vs placebo |
Recruitment period | 1989-1992 | 1984-1989 | 1979-1985 | 1978-7199 |
Median duration of scheduled treatment in original trial (yr) | 6.9 | 2.7 | 4.4 | 6 |
Year post-trial follow up extended to | 2009 | 2007 | 2006 | 2002 |
Table 3 Clinical effects of aspirin on sporadic colorectal cancer (clinical trials)
Rothwell et al meta analysis | Physician’s health study | Women’s health study | |
ASA dosage | 75-1200 mg/d | 325 mg per every other day | 100 mg per every other day |
Duration of follow up (yr) | ≥ 20 | 10 | 10 |
Relative risk of CRC over follow up (HR) | 0.76 (95%CI: 0.60-0.96) | 1.03 (95%CI: 0.83-1.28) | 0.97 (95%CI: 0.77-0.24) |
Table 4 Clinical effects of aspirin in incidence of sporadic colorectal adenomas (clinical trials)
Study | Patients | Treatment | RR (95%CI) |
AFPPS trial | Patients with a recent history of histologically documented (removed) adenomas | ASA (81 or 325 mg/d) or folic acid (1 mg/d) or placebo for 2.7 years | Any adenoma 0.81 (0.69-0.96), ASA 81mg vs non ASA 0.96 (0.81-1.13), ASA 325 mg vs non ASA Advanced lesion 0.59 (0.38-0.92), ASA 81 mg vs non ASA 0.83 (0.55–1.23), ASA 325 mg vs non ASA |
CAPS trial | Patients with a histologically documented colon or rectal cancer with a low risk of recurrent disease | ASA 325 mg/d or placebo for 2.6 years | 0.65 (0.46-0.91) |
APACC trial | Patients with a history of colorectal adenomas | ASA 160 or 300 mg/d or placebo for 1 and 4 years | 0.73 (0.52-1.04) for both doses, after 1 year 0.96 (0.75-1.22), for both doses, after 4 years |
ukCAP trial | Patients with an adenoma removed in the 6 mo before recruitment | ASA (300 mg/d) plus placebo or ASA plus folic acid (0.5 mg/d) or folic acid plus placebo or double placebo for about 2.6 years | Any adenoma 0.79 (0.63-0.99), ASA vs non ASA, Advanced adenoma 0.63 (0.43-0.91), ASA vs non ASA |
J-CAPP trial | Patients with previous sporadic colorectal tumors | ASA 100 mg/d or placebo for 2 years | Ongoing |
Table 5 Clinical effects of aspirin in high risk population (clinical trials)
Study | Patients | Treatment | RR or HR (95%CI) | Ref. |
CAPP1 trial | FAP young patients (10 to 21 years of age) | ASA (600 mg/d) plus placebo or resistant starch (30 g daily) plus placebo or double placebo for 17 years | RR = 0.77 (0.54-1.10), ASA vs non ASA | [22] |
CAPP2 trial | Hereditary non-polyposis colon cancer or HNPCC | ASA (600 mg/d) or ASA placebo or resistant starch (30 g daily) or starch placebo for up to 4 years | HR = 0.63 (0.35-1.13), for the entire post-randomization period (ASA vs placebo) HR = 0.41 (0.19-0.86), for ≥ 2 years of treatment (ASA vs placebo) | [23] |
J-FAPP II trial | FAP patients (≥ 16 years of age) | Placebo vs enteric coated ASA (100 mg/d ) for 6-10 mo | Ongoing | [25] |
- Citation: Sostres C, Gargallo CJ, Lanas A. Aspirin, cyclooxygenase inhibition and colorectal cancer. World J Gastrointest Pharmacol Ther 2014; 5(1): 40-49
- URL: https://www.wjgnet.com/2150-5349/full/v5/i1/40.htm
- DOI: https://dx.doi.org/10.4292/wjgpt.v5.i1.40