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Tipping the Balance: Benefits and Risks of Aspirin in Chemoprevention of Colorectal Cancer

  • Prevention and Early Detection (N Arber, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Convincing evidence now exists to support a clear role for aspirin in the chemoprevention of gastrointestinal malignancies, in particular colorectal cancer. Although much of the data comes from large-scale epidemiological studies, recent randomised controlled trials have added statistically robust evidence to corroborate a beneficial effect of aspirin in the paradigm of chemoprevention, providing a promising avenue for further research into its long-term benefits in this context. The current evidence favours low-dose aspirin: 75-300 mg for 10 years or more in patients at high risk of colorectal cancer is optimal. These putative benefits must be viewed in the light of aspirin’s well-established myriad of side effects, including gastrointestinal and intracerebral haemorrhage. The complex risk–benefit profile of aspirin in general and specific populations is considered in this review.

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Acknowledgment

J.A. Jankowski is supported by a grant from AstraZeneca.

Disclosure

P. Thiagarajan: none; J.A. Jankowski: served as Chief Investigator of the AspECT trial, received compensation from both AstraZeneca and Dr. Falk Pharmaceuticals for serving as a consultant.

Funding

Cancer Research UK

Conflict of interest

J.A J Jankowski Chief Investigator of AspECT trial and received funds from AstraZeneca.

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Authors and Affiliations

  1. Department of Gastroenterology, Queens Medical Centre, Nottingham, NG7 2UH, UK

    Prarthana Thiagarajan

  2. Digestive Disease Centre, Level 4, Windsor Building, Leicester, Royal Infirmary, Leicester, LE1 5WW, UK

    Janusz A. Jankowski

  3. Department of Oncology, University of Oxford, Oxford, OX3 7DQ, UK

    Janusz A. Jankowski

  4. Centre for Digestive Diseases, Queen Mary University of London, London, E1 7AT, UK

    Janusz A. Jankowski

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  1. Prarthana Thiagarajan
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Correspondence to Prarthana Thiagarajan.

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Thiagarajan, P., Jankowski, J.A. Tipping the Balance: Benefits and Risks of Aspirin in Chemoprevention of Colorectal Cancer. Curr Colorectal Cancer Rep 9, 1–8 (2013). https://doi.org/10.1007/s11888-012-0151-4

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