PT  - JOURNAL ARTICLE
AU  - Farhat V N Din
AU  - Evropi Theodoratou
AU  - Susan M Farrington
AU  - Albert Tenesa
AU  - Rebecca A Barnetson
AU  - Roseanne Cetnarskyj
AU  - Lesley Stark
AU  - Mary E Porteous
AU  - Harry Campbell
AU  - Malcolm G Dunlop
TI  - Effect of aspirin and NSAIDs on risk and survival from colorectal cancer
AID  - 10.1136/gut.2009.203000
DP  - 2010 Dec 01
TA  - Gut
PG  - 1670--1679
VI  - 59
IP  - 12
4099  - http://gut.bmj.com/content/59/12/1670.short
4100  - http://gut.bmj.com/content/59/12/1670.full
SO  - Gut2010 Dec 01; 59
AB  - Background Previous studies have shown that aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) lower colorectal cancer (CRC) risk. However, the lowest effective NSAID dose, treatment duration, and effects on survival are not defined. In a large population-based case–control study, we have explored the relationship between NSAID dose and duration, CRC risk and overall CRC-specific survival.Methods The relationship between NSAID use and CRC risk was examined in 2279 cases and 2907 controls. Subjects completed food-frequency and lifestyle questionnaires. NSAID categories were low-dose aspirin (75 mg), non-aspirin NSAIDs (NA-NSAIDs) and any NSAID. Users were defined as taking >4 tablets/week for >1 month. ORs were calculated by logistic regression models and adjusted for potential confounding factors. Effect of NSAID use on all-cause and CRC-specific mortality was estimated using Logrank tests and Cox's hazard models.Results In all, 354 cases (15.5%) were taking low-dose aspirin compared to 526 controls (18.1%). Low-dose aspirin use was associated with decreased CRC risk (OR 0.78 95% CI 0.65 to 0.92, p=0.004), evident after 1 year and increasing with duration of use (ptrend=0.004). NA-NSAID and any NSAID use were also inversely associated with CRC. There was no demonstrable effect of NSAIDS on all-cause (HR 1.11, p=0.22, 0.94–1.33) or CRC-specific survival (HR 1.01, p=0.93, 0.83–1.23).Conclusion This is the first study to demonstrate a protective effect against CRC associated with the lowest dose of aspirin (75 mg per day) after only 5 years use in the general population. NSAID use prior to CRC diagnosis does not influence survival from the disease.