Colon
Aspirin May Reduce Risk of Colon Cancer Recurrence
By American Society of Clinical Oncology
May 17, 2005, 01:54

Researchers from the Cancer and Leukemia Group B (CALGB), a national clinical research group in the United States, found that regular aspirin use among colon cancer patients following surgery reduced the risk of recurrence and death by approximately 50% compared with non-users.

The study, which was primarily designed to assess post-operative adjuvant chemotherapy in stage III colon cancer patients, also demonstrated a benefit to using aspirin in people who have already been diagnosed with colon cancer. A beneficial effect was also seen with celecoxib (Celebrex) and rofecoxib (Vioxx). No such benefit was found with regular acetaminophen use.

Previous studies in both animals and people have shown that regular aspirin use may reduce the risk of developing colon cancer and benign growths called polyps. Animal studies have also suggested that the benefits of aspirin may extend to people who already have colon cancer, by reducing their risk of recurrence.

Researchers prospectively studied 830 patients with stage III colon cancer undergoing post-operative adjuvant chemotherapy to analyze the relationship between aspirin and cancer recurrence. They also evaluated the relationship between cancer recurrence and selective cyclo-oxygenase-2 (COX-2) inhibitors, such as celecoxib and rofecoxib.
Participants completed surveys about their use of aspirin and other medications midway through therapy and six months after completion of treatment. Consistent aspirin use was reported by 8.7% of the patients (most of whom took 81 mg to 325 mg per day), while 4.3% of patients reported regular use of celecoxib or rofecoxib.

After a median of 2.4 years of follow-up, the risk of colon cancer recurrence was 55% lower and the risk of death was 48% lower among the aspirin users compared with non-users. Although no dose-response analysis was reported, the benefit of aspirin persisted independent of dose, as long as the patient consistently took aspirin throughout the follow-up period. Use of celecoxib or rofecoxib reduced the risk of recurrence by 44%.

"While aspirin appears to reduce the risk of cardiovascular disease, it may be premature to advise colorectal cancer patients to start taking aspirin regularly for the purpose of reducing their risk of recurrence," said Charles Fuchs, MD, MPH, Associate Professor of Medicine at the Dana-Farber Cancer Institute in Boston, and the study's lead author. "More studies are clearly needed to confirm our findings. People with colon cancer who are interested in taking aspirin should first speak with their doctors." Dr. Fuchs added that another study evaluating the use of celecoxib in patients with colon cancer is ongoing.


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