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Band 27, No. 4, 2011
Issue release date: August 2011
Section title: Main Topic · Hauptthema
Viszeralmedizin 2011;27:322–328
(DOI:10.1159/000331228)

Chemoprevention

Burn J.
Institute of Genetic Medicine, International Centre for Life, Newcastle University, Newcastle upon Tyne, UK

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Article / Publication Details

First-Page Preview
Abstract of Main Topic · Hauptthema

Published online: 8/13/2011
Issue release date: August 2011

Number of Print Pages: 0
Number of Figures: 0
Number of Tables: 0

ISSN: 1662-6664 (Print)
eISSN: 1662-6672 (Online)

For additional information: http://www.karger.com/VIM

Abstract

Observational studies show that aspirin reduces colorectal cancer (CRC), especially with prolonged use. In four adenoma prevention randomized controlled trials (RCTs), aspirin at any dose reduced the risk of a colorectal adenoma by an average of 17% and advanced adenomas by 28%. Registry follow-up for a median of 18 years after five RCTs showed that treatment with any aspirin dose reduced the 20-year CRC risk by 24% and the CRC-associated mortality by 35%. A meta-analysis of eight trials with a total of 25,570 patients showed a 21% lower risk of death from any cancer. The trial CAPP1(Concerted Action Polyposis Prevention 1) tested aspirin 600 mg/day and/or resistant starch 30 g/day in 200 adolescent familial adenomatous polyposis carriers. Aspirin treatment resulted in a non-significant reduction in polyp number and a significant reduction in polyp size among patients treated with aspirin for more than 1 year. The CAPP2 RCT used the same interventions in 937 Lynch syndrome (LS) patients, which was the first RCT to have cancer prevention as a primary endpoint. Aspirin did not reduce the risk of colorectal neoplasia in a mean treatment period of 29 months but double-blind post-intervention follow-up has revealed that 48 participants developed 53 CRCs. Protocol analysis showed 60% fewer cancers with aspirin (p = 0.02) apparent from 4 years, with a similar effect on other LS cancers. CAPP3 will involve a double-blind dose inferiority trial comparing 100, 300 or 600 mg daily in 3,000 gene carriers. We can now recommend aspirin in people at high risk of CRC.

© 2011 S. Karger AG, Basel


  

Author Contacts

Prof. Sir John Burn, MD FRCP FRCPCH FRCOG FMedSci, Institute of Genetic Medicine, International Centre for Life, Newcastle University, Central Parkway, Newcastle upon Tyne, NE1 3BZ, UK, Tel. +44 191 2418611, john.burn@newcastle.ac.uk

  

Article Information

Online publiziert: 13. August 2011
Number of Print Pages : 7

  

Publication Details

Viszeralmedizin (Gastrointestinal Medicine and Surgery)

Vol. 27, No. 4, Year 2011 (Cover Date: August 2011)

Journal Editor: Klar E. (Rostock), Mössner J. (Leipzig), Lohse A.W. (Hamburg)
ISSN: 1662-6664 (Print), eISSN: 1662-6672 (Online)

For additional information: http://www.karger.com/VIM


Article / Publication Details

First-Page Preview
Abstract of Main Topic · Hauptthema

Published online: 8/13/2011
Issue release date: August 2011

Number of Print Pages: 0
Number of Figures: 0
Number of Tables: 0

ISSN: 1662-6664 (Print)
eISSN: 1662-6672 (Online)

For additional information: http://www.karger.com/VIM


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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