ASPIRIN MAY HELP BLOCK COLON, RECTAL CANCERS

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ASPIRIN MAY HELP BLOCK COLON, RECTAL CANCERS
06 March 2002 - University of Chicago

Two new studies suggest that aspirin, already used to help prevent heart disease and stroke, also can prevent colon and rectal cancers in high-risk patients, though doctors say it's too early to recommend routine aspirin therapy for such cancers.

A study of patients with a history of precancerous growths called polyps found that taking a low-dose baby aspirin once a day reduced the likelihood of new polyps by 19 percent. Nearly all colorectal cancers begin as polyps on the bowel wall.

A second study of colorectal cancer survivors found that taking one adult-dose aspirin a day reduced the likelihood of new polyps by 35 percent.

"We know from these two papers that aspirin is effective in preventing polyps, but we still do not know the best dose," said Dr. Robert Sandler of the University of North Carolina, a co-author of both studies, which are published in today's New England Journal of Medicine.

The American Cancer Society estimates there will be 147,500 new cases and 57,100 deaths this year.

Aspirin is a blood thinner that can prevent clotting. Studies have shown aspirin reduces the risk of heart attacks, strokes and angina in high-risk patients.

Aspirin also inhibits an enzyme, known as COX-2, that appears in colorectal cancer tissue. Nevertheless, patients at high risk for colorectal cancer should not take aspirin without first consulting their doctors, the researchers said. Aspirin can irritate the stomach lining and cause stomach bleeding, rash, nausea and ringing in the ears.

Also, aspirin should not be a substitute for screening and surveillance, said Dr. Richard Schilsky of the University of Chicago, senior author of the cancer survivor study. Screening tests include checking the stool for hidden blood, X-raying the colon and viewing the colon with a flexible lighted tube.

About 90 percent of adults over age 50 are considered to be at average risk for colorectal cancer.

For these people, the risks of aspirin probably outweigh the benefits, Dr. Thomas Imperiale of Indiana University medical school wrote in a separate article in the New England Journal. Aspirin "saves fewer lives at higher costs than does screening for colorectal cancer by any method and is not beneficial among persons at average risk who follow screening recommendations," Imperiale wrote.

The arthritis drug Celebrex also has shown promise in preventing polyps. Like aspirin, Celebrex is a COX-2 inhibitor. Celebrex doesn't have the side effects of aspirin, but requires a prescription and can cost more than $2 a pill. Researchers recently completed a major nationwide trial of Celebrex, but results have not been published.

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About: University of Chicago
The University of Chicago was founded in 1890 by the American Baptist Education Society and oil magnate John D. Rockefeller. The land for the new university, in the recently annexed suburb of Hyde Park, was donated by Marshall Field, owner of the Chicago department store that bears his name.

In 1929, Robert Hutchins became the University's fifth president. During his tenure, Hutchins established many of the undergraduate curricular innovations that the University is known for today. These included a curriculum dedicated specifically to interdisciplinary education, comprehensive examinations instead of course grades, courses focused on the study of original documents and classic works, and an emphasis on discussion, rather than lectures.

During the late 1950s and early 1960s, the University began to add modern buildings to the formerly all-Gothic campus.

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