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Sunday, December 2, 2012

Aspirin and colon cancer



About 6% of Americans will develop colon cancer in their life time.   Several randomized trials showed that taking aspirin once a day reduced in patient taking aspirin for many years period.  The risk reduction seemed to improve as we take aspirin longer.   

1121 patients with a history of adenomas were randomized into aspirin (81 or 325 mg daily) or placebo. A follow-up colonoscopy was performed at least one year after study entry in 1084 patients (97 percent). The risk of recurrent adenomas was significantly lower in the 81 mg group compared with placebo (38 versus 47 percent, RR 0.81, 95% CI 0.69-0.96). The risk reduction was even greater for the development of advanced neoplasms (RR 0.59, 95% CI 0.38-0.92). For unclear reasons, the 325 mg dose was not associated with a significantly reduced risk of adenoma recurrence

Another study was on 517 patients with a history of colorectal cancer who were randomly assigned to aspirin (325 mg/day) or placebo.  Recurrent adenomas were observed significantly less often in the aspirin group (17 versus 25 percent, RR 0.65, 95% CI 0.46-0.91) during a colonoscopy performed at a median of 13 months after randomization.

Another  trial (945 patients with a history of an adenoma)  were randomly assigned to aspirin (300 mg daily), folic acid supplementation (0.5 mg daily), or placebo.  Aspirin supplementation but not folic acid was associated with a significantly reduced risk of recurrent adenomas

There are controversies of the dose of aspirin.   In light of aspirin could cause other complications (stomach/bowel bleeding, bleeding in the brain, stomach pain, etc), I recommend taking 81mg (baby aspirin) aspirin a day.  Be extra careful if you take any blood thinners (Plavix, coumadin, etc) because the combinations of aspirin and other blood thinners may cause excess bleeding.   Do talk to your doctor before you start this.  Buy the generic aspirin - cheaper and equally effective.

Reference:
- Uptodate.  Accessed 12-2-12

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