Aspirin Use Causes Sizeable Drop In Colorectal Cancer Case — Experts

The regular use of aspirin or other nonsteroidal anti-inflammatory drugs could prove to be an effective strategy in preventing early-onset colorectal cancer cases, experts in a study have said.

Researchers, in a new study, found with aspirin use, a 15 percent reduction for all adenomas and 33 percent for those with advanced histology, which is quite substantial.

Dr Cassandra D. Fritz, a gastroenterologist with Washington University, St. Louis, in an oral presentation given at the annual Digestive Disease Week, said, “This finding is important, given the alarming rise in the incidence and mortality of early-onset colorectal cancer in people less than 50 years old and our limited understanding of the underlying drivers to direct prevention efforts.”

The study confirms evidence from 30 years of research that suggests regular aspirin use reduces cancer risk. In patients with Lynch syndrome, the CAPP2 study showed that aspirin has a protective effect against colorectal cancer at 20 years follow-up.

While emerging data have suggested that aspirin use may reduce later-onset colorectal cancer, it was not known if regular aspirin and NSAID use are associated with diminished risk of early-onset conventional adenomas and, especially, the high-risk adenomas conferring greater malignant potential known to be the major precursor of early-onset colorectal cancer.

The objective of the new study was to assess the association between regular aspirin or NSAID use at least twice weekly, with the risk of developing early-onset adenoma.

The analysis is based on an evaluation of data from the Nurses’ Health Study II of 32,058 women who had at least one colonoscopy before age 50 (1991-2015).

The risk of adenomas among patients who took aspirin or NSAIDs regularly for cardiovascular protection or for inflammatory conditions was lower than in those who did not take aspirin and/or NSAIDs regularly.

While the association was similar for high-risk vs low-risk adenomas, the benefit was more pronounced for adenomas of tubulovillous/villous histology or with high-grade dysplasia, a 33 percent reduction, compared with tubular adenomas.

The U.S. Preventive Services Task Force issued a new recommendation in 2021 stating that colorectal cancer screening for people with average risk should start five years sooner at age 45.

Many younger adults are not screened; reason experts are looking into potential early-onset colorectal cancer chemo-preventive agents.