Should Aspirin Be Used to Prevent Colorectal Cancer?

Colorectal cancer and aspirin therapy debate continues at ESMO 2012

(RxWiki News) Increasingly, scientists are linking inflammation with cancer. A classic drug choice to treat inflammation is aspirin. Is this drug ready for primetime in the cancer fight? Well, it depends who you ask.

Two experts in the colorectal cancer and aspirin arena duked it out at ESMO 2012 European Society for Medical Oncology Congress in Vienna.

Included in the aspirin category are non-steroidal anti-inflammatory drugs (NSAID), including such brand names as Aleve, Advil, Bayer and Motrin.

"Ask your doctor about aspirin therapy."

In the aspirin corner, there is Prof Robert Benamouzig from the Department of Gastroenterology at the Avicenne Hospital in Bobigny, France.

"The efficacy of aspirin in preventing colorectal cancer has been made obvious by more than twenty years of research," said Prof Benamouzig.

"In 2010, researchers published the 20-year follow-up of five pooled randomized trials that assessed the effect of aspirin on colorectal cancer incidence and mortality, Prof Benamouzig said in an ESMO press release.

“The study of more than 14,000 patients found that daily aspirin at any dose reduced risk of colorectal cancer by 24 percent and associated deaths by 35 percent after a delay of about 8 to 10 years."

Prof Benamouzig concluded that “the evidence that aspirin is effective for preventing these colorectal cancers is very strong.”

And in the other corner, representing the opposite view of aspirin as a preventive agent for colorectal cancer is Prof Nadir Arber, director of Integrated Cancer Prevention at the Tel Aviv Sourasky Medical Center in Israel.

"NSAIDs, and in particular aspirin, are very promising in secondary prevention of colorectal neoplasia, however their role in primary prevention is still not proven," Prof Arber said in the same press release.

"This means that the majority of the population does not need, and is not going to benefit from aspirin use.”

Prof Arber added that people who are high-risk for colorectal cancer because of either a family history, existing cancer or pre-cancerous lesions “definitely can benefit from aspirin intake.”

According to Prof Arber, the key next steps will be further research to determine a way to predict who would benefit from aspirin therapy without the side effects.

Risks associated with taking aspirin are bleeding in the gastrointestinal tract and brain hemorrhage.

"We need a study that will measure overall morbidity and mortality and not efficacy and toxicity in a single organ or disease such as cardio-vascular disease," Prof Arber said.

Review Date: 
October 1, 2012