The use of aspirin in prevention of colorectal cancer in people at increased risk

Abstract

Topic Overview: Colorectal cancer (CRC) is one of the most common cancers worldwide and leads to high rates of morbidity and mortality. Some individuals have a higher risk of this disease such as those who are elderly, carriers of Lynch syndrome or related to persons with a history of colon cancer. Current practices consist of aspirin having a role for prevention of cardiovascular events but not as a chemopreventive agent, however, evidence implies that it is effective against the development of CRC. The Research Question: Does aspirin prevent colorectal cancer in people who are at an increased risk of developing this disease? The PEO Elements: 1. Population : People at increased risk 2. Exposure : Aspirin 3. Outcome : Prevention of colorectal cancer Inclusion and Exclusion Criteria: The main criteria included studies in the English language, published in the last 10 years, peer-reviewed and in full text. Articles selected investigated CRC risk reduction as the primary outcome, mixed gender participants and all age groups. Studies on animals, cost-effectiveness, treatment of CRC and with less than 15 participants were excluded. Search Outcome: The literature search results in nine studies consisting of one meta-analysis, one systematic review, two randomised controlled trials and five cohort studies. Methods of Appraisal: The Critical Appraisal Skills Programme checklists were used for the appraisal of the studies. Studies’ Results: The exposure of aspirin was associated with a reduced incidence of CRC. Main Conclusions: Aspirin was found to be effective in decreasing the risk of CRC, however, more research is required regarding this topic to outweigh the benefits as there are potential harms related to the use of aspirin. Implications and Recommendations: Introducing aspirin as chemoprevention may be liable to numerous controversies such as extra expenses, its adverse effects and its appropriateness for the individual. Prior to its implentation, local trials should be carried out for the evaluation of its effects.