Effect of aspirin and NSAIDs on risk and survival from colorectal cancer

Farhat V N Din ¹, Evropi Theodoratou , Susan M Farrington

⁰Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh and MRC Human Genetics Unit, Western General Hospital, Edinburgh EH4 2XU, UK.

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September 17, 2010

View abstract on PubMed

Summary

Low-dose aspirin (75 mg) use is linked to reduced colorectal cancer (CRC) risk in the general population. However, non-steroidal anti-inflammatory drug (NSAID) use does not appear to impact survival after CRC diagnosis.

Area Of Science

Oncology
Pharmacology
Epidemiology

Background

Non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, are known to reduce colorectal cancer (CRC) risk.
Optimal NSAID dosage, duration for risk reduction, and impact on survival remain undefined.
This study investigates NSAID dose and duration in relation to CRC risk and survival.

Purpose Of The Study

To determine the lowest effective dose and duration of NSAID use for colorectal cancer (CRC) risk reduction.
To examine the association between NSAID use and CRC risk.
To evaluate the impact of NSAID use on overall and CRC-specific survival.

Main Methods

A large population-based case-control study involving 2279 CRC cases and 2907 controls.
Data collected via food-frequency and lifestyle questionnaires.
Analysis included logistic regression for risk and Logrank/Cox models for survival, categorizing NSAID use by dose (low-dose aspirin, non-aspirin NSAIDs) and duration.

Main Results

Low-dose aspirin (75 mg) use was associated with a significant reduction in CRC risk (OR 0.78, p=0.004), with protective effects increasing with duration.
Non-aspirin NSAIDs and any NSAID use also showed inverse associations with CRC risk.
No significant effect of NSAID use was observed on all-cause (HR 1.11, p=0.22) or CRC-specific mortality (HR 1.01, p=0.93).

Conclusions

This study provides the first evidence of a protective effect of low-dose aspirin (75 mg/day) against CRC in the general population, evident after 5 years of use.
NSAID use prior to CRC diagnosis does not influence survival outcomes for the disease.
Findings highlight the potential of low-dose aspirin for CRC prevention, but not as a treatment to improve survival.

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