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NSAIDs and Aspirin Show Efficacy in Prevention of Colorectal Cancer

NSAIDs and Aspirin Show Efficacy in Prevention of Colorectal Cancer

SEATTLE—Regular use of non-steroidal anti-inflammatory drugs (NSAIDs) and
aspirin lowers the relative risk of colorectal cancer by an overall rate of
24%, according to a study presented at the 67th Annual Scientific Meeting of
the American College of Gastroenterology (abstract 12). The rate rises to 32%
when aspirin/NSAIDs are used for more than 2 years.

"We have known for years that regular use of NSAIDs lowers the risk of
colorectal cancer anywhere from 30% to 50%," said Jia-Qing Huang, MD,
research associate, Division of Gastroenterology, McMaster University,
Hamilton, Ontario, Canada. Richard H. Hunt, MD, professor of medicine, was
senior author of the study.

While combined evidence from epidemiological, clinical, and animal studies
has shown that NSAIDs are effective in reducing the risk of developing
colorectal cancer, long-term use and the magnitude of effect remained
unevalu-ated, Dr. Huang noted.

The researchers performed a systematic search of the literature up to
March 2002. They found eight case-control studies and five cohort studies
that met the predefined eligibility criteria.

The case-control studies involved 13 study arms, with nearly 12,000
patients and more than 43,000 controls. Statistical combination of these
studies showed overall aspirin/NSAIDs use among 14.4% of colorectal cancer
patients vs 26% of controls. With an odds ratio of 0.76 and a 95% confidence
interval of 0.67 to 0.86, the analysis shows a clear protective effect, Dr.
Huang said.

In a subanalysis, the investigators found that the magnitude of the
protective effect was equal for both NSAIDs and aspirin.

In the five cohort studies, the incidence of colorectal cancer was 5 per
10,000 person-years among NSAID users vs 5.3 per 10,000 person-years in
controls, showing a relative risk of 0.81 (95% CI: 0.72 to 0.92).


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