 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Several studies show that taking aspirin helps prevent adenomas and thus colorectal cancer. Some studies suggest that short-term aspirin use can prevent adenomas. Other studies show that only long-term aspirin use can prevent them. In addition, some studies suggest that low-dose aspirin use does not work, while others suggest that low doses of aspirin do prevent adenomas.
SUMMARIES FOR PATIENTS
Relationships between Aspirin Dose and Colorectal Adenomas
3 February 2004 | Volume 140 Issue 3 | Page I-24
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full report titled "A Prospective Study of Aspirin Use and the Risk for Colorectal Adenoma." It is in the 3 February 2004 issue of Annals of Internal Medicine (volume 140, pages 157–166). The authors are A.T. Chan, E.L. Giovannucci, E.S. Schernhammer, G.A. Colditz, D.J. Hunter, W.C. Willett, and C.S. Fuchs.
What is the problem and what is known about it so far?
Colorectal cancer is cancer of the colon (large intestine) or rectum. Most colorectal cancer develops from small growths called polyps. Adenomas, which are the most common type of polyp, are the only type that can become cancer. Doctors use flexible tubular instruments to examine the colon (colonoscopy or sigmoidoscopy) and find polyps. To distinguish adenomas from other types of polyps, they remove or take pieces of them (biopsies) and send the tissue for special examination (histologic examination).
Why did the researchers do this particular study?
To study the doses and the duration of use of aspirin that prevent colorectal adenomas.
Who was studied?
27 077 female nurses in the United States who had colonoscopy or sigmoidoscopy between 1980 and 1998. The nurses were 34 to 77 years of age and had no known history of colon disease, including adenomas or cancer, when they started the study.
How was the study done?
Beginning in 1976, the researchers mailed questionnaires every 2 years to the nurses. They asked about medical history and risk factors for cancer and heart disease. From 1980 through 1998, the researchers added questions about aspirin use and colonoscopy or sigmoidoscopy. The researchers reviewed the medical records of women who reported having these procedures to find out which women had polyps and then looked at the biopsy results for the polyps. They did not know which women had reported taking aspirin when they looked at these results. The researchers then compared reported aspirin use before the colon procedure among women with and without adenomas.
What did the researchers find?
Higher doses of aspirin were associated with lower risks for adenomas. Women who reported taking more than 14 aspirin tablets weekly had the lowest risk, and women who reported never using or rarely using aspirin had the highest risk. After aspirin dose and other risk factors for adenomas were taken into account, using aspirin for several years was not associated with lower risk than was using aspirin for shorter periods.
What were the limitations of the study?
Women self-reported aspirin use. Some may not have correctly remembered how often they used aspirin. In addition, the researchers could not assess exact doses (milligrams) that the women used.
What are the implications of the study?
Higher aspirin doses are associated with lower risks for colorectal adenomas than are lower doses. However, higher doses increase risks for adverse effects, such as bleeding, and lower doses prevent heart disease. People should not take higher doses of aspirin to prevent colorectal adenomas until more studies clearly define the overall benefits and harms of these doses.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  D. Z. J. Chu, G. Gibson, D. David, and Y. Yen The Surgeon's Role in Cancer Prevention. The Model in Colorectal Carcinoma Ann. Surg. Oncol., November 1, 2007; 14(11): 3054 - 3069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Kune Commentary: Aspirin and cancer prevention Int. J. Epidemiol., October 5, 2007; (2007) dym194v1. [Full Text] [PDF]
|
|
|
|
 |
|
 L. Madlensky, D. Daftary, T. Burnett, P. Harmon, M. Jenkins, J. Maskiell, S. Nigon, K. Phillips, A. Templeton, P. J. Limburg, et al. Accuracy of Colorectal Polyp Self-Reports: Findings from the Colon Cancer Family Registry Cancer Epidemiol. Biomarkers Prev., September 1, 2007; 16(9): 1898 - 1901. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Chan, S. Ogino, and C. S. Fuchs Aspirin and the Risk of Colorectal Cancer in Relation to the Expression of COX-2 N. Engl. J. Med., May 24, 2007; 356(21): 2131 - 2142. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Oh, W. C. Willett, K. Wu, C. S. Fuchs, and E. L. Giovannucci Calcium and Vitamin D Intakes in Relation to Risk of Distal Colorectal Adenoma in Women Am. J. Epidemiol., May 15, 2007; 165(10): 1178 - 1186. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Chan, J. E. Manson, D. Feskanich, M. J. Stampfer, G. A. Colditz, and C. S. Fuchs Long-term Aspirin Use and Mortality in Women Arch Intern Med, March 26, 2007; 167(6): 562 - 572. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U.S. Preventive Services Task Force* Routine Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement Ann Intern Med, March 6, 2007; 146(5): 361 - 364. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Dube, A. Rostom, G. Lewin, A. Tsertsvadze, N. Barrowman, C. Code, M. Sampson, and D. Moher The Use of Aspirin for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force Ann Intern Med, March 6, 2007; 146(5): 365 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Rostom, C. Dube, G. Lewin, A. Tsertsvadze, N. Barrowman, C. Code, M. Sampson, and D. Moher Nonsteroidal Anti-inflammatory Drugs and Cyclooxygenase-2 Inhibitors for Primary Prevention of Colorectal Cancer: A Systematic Review Prepared for the U.S. Preventive Services Task Force Ann Intern Med, March 6, 2007; 146(5): 376 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. A. Hubner, K. R. Muir, J.-F. Liu, R. F.A. Logan, M. Grainge, N. Armitage, V. Shepherd, S. Popat, R. S. Houlston, and the United Kingdom Colorectal Adenoma Prevention C Genetic Variants of UGT1A6 Influence Risk of Colorectal Adenoma Recurrence. Clin. Cancer Res., November 1, 2006; 12(21): 6585 - 6589. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Mahipal, K. E. Anderson, P. J. Limburg, and A. R. Folsom Nonsteroidal Anti-inflammatory Drugs and Subsite-Specific Colorectal Cancer Incidence in the Iowa Women's Health Study. Cancer Epidemiol. Biomarkers Prev., October 1, 2006; 15(10): 1785 - 1790. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. B. Michels, E. Giovannucci, A. T. Chan, R. Singhania, C. S. Fuchs, and W. C. Willett Fruit and vegetable consumption and colorectal adenomas in the Nurses' Health Study. Cancer Res., April 1, 2006; 66(7): 3942 - 3953. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Tanaka, A Tatsuguchi, S Futagami, K Gudis, K Wada, T Seo, K Mitsui, M Yonezawa, K Nagata, S Fujimori, et al. Monocyte chemoattractant protein 1 and macrophage cyclooxygenase 2 expression in colonic adenoma Gut, January 1, 2006; 55(1): 54 - 61. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Chan, E. L. Giovannucci, J. A. Meyerhardt, E. S. Schernhammer, G. C. Curhan, and C. S. Fuchs Long-term Use of Aspirin and Nonsteroidal Anti-inflammatory Drugs and Risk of Colorectal Cancer JAMA, August 24, 2005; 294(8): 914 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. R. Cook, I-M. Lee, J. M. Gaziano, D. Gordon, P. M Ridker, J. E. Manson, C. H. Hennekens, and J. E. Buring Low-Dose Aspirin in the Primary Prevention of Cancer: The Women's Health Study: A Randomized Controlled Trial JAMA, July 6, 2005; 294(1): 47 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fux, M. Schwab, K.-P. Thon, C. H. Gleiter, and P. Fritz Cyclooxygenase-2 Expression in Human Colorectal Cancer Is Unrelated to Overall Patient Survival Clin. Cancer Res., July 1, 2005; 11(13): 4754 - 4760. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. T. Chan, J. Ma, G. J. Tranah, E. L. Giovannucci, N. Rifai, D. J. Hunter, and C. S. Fuchs Hemochromatosis Gene Mutations, Body Iron Stores, Dietary Iron, and Risk of Colorectal Adenoma in Women J Natl Cancer Inst, June 15, 2005; 97(12): 917 - 926. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Oh, W. C. Willett, C. S. Fuchs, and E. Giovannucci Dietary Marine n-3 Fatty Acids in Relation to Risk of Distal Colorectal Adenoma in Women Cancer Epidemiol. Biomarkers Prev., April 1, 2005; 14(4): 835 - 841. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Chan, G. J. Tranah, E. L. Giovannucci, D. J. Hunter, and C. S. Fuchs Genetic Variants in the UGT1A6 Enzyme, Aspirin Use, and the Risk of Colorectal Adenoma J Natl Cancer Inst, March 16, 2005; 97(6): 457 - 460. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Aceves, A. Duenas, C. Gomez, E. San Vicente, M. S. Crespo, and C. Garcia-Rodriguez A New Pharmacological Effect of Salicylates: Inhibition of NFAT-Dependent Transcription J. Immunol., November 1, 2004; 173(9): 5721 - 5729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. M Gatto, U. B Campbell, A. G Rundle, and H. Ahsan Further development of the case-only design for assessing gene-environment interaction: evaluation of and adjustment for bias Int. J. Epidemiol., October 1, 2004; 33(5): 1014 - 1024. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Scovern Aspirin Use and Risk for Colorectal Adenoma Ann Intern Med, September 7, 2004; 141(5): 406 - 406. [Full Text] [PDF]
|
|
|
|
 |
|
 Minerva BMJ, May 15, 2004; 328(7449): E299 - E299. [Full Text] [PDF]
|
|
|
|
 |
|
 A prospective study of aspirin use and the risk for colorectal adenoma Obstet. Gynecol., May 1, 2004; 103(5): 994 - 994. [Full Text] [PDF]
|
|
|
|
|
|
Minerva BMJ, February 28, 2004; 328(7438): 532 - 532. [Full Text] [PDF]
|
|
|
|
|
|
Some Recent Articles on Aspirin and Cancer J Natl Cancer Inst, February 18, 2004; 96(4): 253 - 253. [Full Text] [PDF]
|
|
|
|
|
|
R. S. Sandler Aspirin Prevention of Colorectal Cancer: More or Less? Ann Intern Med, February 3, 2004; 140(3): 224 - 225. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Article
