COMMENTARY

Aspirin

Aspirin: still learning about the wonder drug

E T Hawk, J L Viner

Gastrointestinal and Other Cancers Research Group, National Cancer Institute, Division of Cancer Prevention, Bethesda, Maryland, USA

Correspondence to:
Correspondence to:
Dr E T Hawk
Gastrointestinal and Other Cancers Research Group, National Cancer Institute, Division of Cancer Prevention, EPN, Suite 2141, 6130 Executive Boulevard, Bethesda, MD 20892-7317, USA; eh51p@nih.gov

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Aspirin, taken daily over at least one year, may exert chemopreventive effects against the early stages of colorectal carcinogenesis

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Keywords: aberrant crypt foci; aspirin; chemoprevention; colon cancer; non-steroidal anti-inflammatory drugs

The first 150 words of the full text of this article appear below.

Preclinical, observational, and clinical data consistently show that non-steroidal anti-inflammatory drugs (NSAIDs)—particularly aspirin—reduce colorectal carcinogenesis.¹ Scores of animal studies show that NSAIDs inhibit the development of colorectal neoplasia across the spectrum of disease, ranging from aberrant crypt foci (ACF) to cancer.² Human data confirm these findings with dozens of observational studies reporting 40–50% reductions in colorectal adenoma incidence, cancer incidence, and cancer associated mortality among aspirin users. The most compelling data were published earlier this year. Two randomised placebo controlled trials conducted in patients at moderate risk for colorectal cancer reported that aspirin administered at doses as low as 81–325 mg/day reduced the development of adenomas by up to 35% after a few years of use.^3,4 In one trial, greater effects were seen against more advanced lesions.³

Colorectal adenomas are established as common non-obligate precursors of colorectal cancer.⁵ Within the last decade, ACF have been identified in rodent models . . . [Full text of this article]

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