Global Perspectives on Treatment of Metastatic Colorectal Cancer - Episode 5

Daily Aspirin for Colorectal Cancer Prevention

Studies have evaluated whether the use of daily aspirin can reduce the risk of developing cancer or dying from cancer, states Dick Arnold, MD, PhD. Recent findings have shown that individuals with stage III colorectal cancer (CRC) who took aspirin had lower rates of cancer-related death. The conclusion from these various investigations is that patients with CRC should take aspirin, suggests John L. Marshall, MD.

In a study conducted in Northern Denmark, the impact of low-dose aspirin use between 1994 and 2011 was explored among 10,280 individuals, with a control arm of 102,800 participants. This study found that continuous long-term use of low-dose aspirin for ≥5 years was associated with a 27% reduction in the risk of CRC. However, those who met these criteria comprised only a small proportion of the study population.

A US-based study is examining the use of 3 months or 6 months of FOLFOX (oxaliplatin, leucovorin, and fluorouracil) with or without 3 years of maintenance therapy with celecoxib, a cyclooxygenase-2 (COX-2) selective inhibitor, notes Marshall. This phase III study will assess disease-free survival rates in patients with stage III CRC following surgery.

Overall, there are many factors than can influence CRC risk, including exercise, vitamin D, and diet. The risk/benefit profile for adding aspirin therapy may be altered in individuals with a good diet who at low risk for developing cancer, states Fortunato Ciardiello, MD, PhD.