Aspirin chemoprevention works for those with genetic colon cancer

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People suffering from Lynch Syndrome, a genetic disease carried by about one in every 1000 people, have at least a 10-fold increased risk of developing colorectal cancer (CRC), compared to the general population. Out of the approximately 160,000 new cases of CRC that occur in the U.S. every year, Lynch Syndrome accounts for about 8,000. But a new study published in The Lancet provides hope for these patients, as it demonstrates that aspirin may reduce their risk of CRC.

In a randomized trial of 861 people with Lynch Syndrome, participants were prescribed either 600 mg of aspirin daily or a placebo over the course of at least two years. After five years of follow-up, researchers from Newcastle University in the U.K. found that those in the aspirin group had an overall 44 percent reduced incidence of CRC, while those who were proven to have adhered to the aspirin regimen for at least two years decreased their risk of the disease by over 60 percent, compared to the control group.

These encouraging results provide a basis for recommending aspirin chemoprevention as the standard of care for Lynch Syndrome patients, the study authors suggest, though the optimal dose of the drug must still be worked out.

Also important, as ACSH's Dr. Gilbert Ross points out, is that, as opposed to the more common variety of colon cancers, the colon cancer found among Lynch Syndrome patients is not associated with polyp formation. Furthermore, diagnosis of cancer in these patients occurs at a much younger age 44 years old, as compared to about 64 years of age in people without the condition. It s now worth examining, he says, whether using aspirin to prevent CRC in people with other risk factors such as familial adenomatous polyposis, chronic ulcerative colitis, and Crohn s disease will yield the same beneficial results.

However, notes ACSH s Dr. Josh Bloom, 600 mg of aspirin per day is not a trivial dose. And side effects, especially bleeding disorders and ulcers, will be a problem for some people. The latter can be controlled, but not eliminated, by using over-the-counter acid reducers, proton pump inhibitors like Prilosec, or a histamine blocker such as Zantac.