Tipping the Balance: Benefits and Risks of Aspirin in Chemoprevention of Colorectal Cancer
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- Thiagarajan, P. & Jankowski, J.A. Curr Colorectal Cancer Rep (2013) 9: 1. doi:10.1007/s11888-012-0151-4
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Convincing evidence now exists to support a clear role for aspirin in the chemoprevention of gastrointestinal malignancies, in particular colorectal cancer. Although much of the data comes from large-scale epidemiological studies, recent randomised controlled trials have added statistically robust evidence to corroborate a beneficial effect of aspirin in the paradigm of chemoprevention, providing a promising avenue for further research into its long-term benefits in this context. The current evidence favours low-dose aspirin: 75-300 mg for 10 years or more in patients at high risk of colorectal cancer is optimal. These putative benefits must be viewed in the light of aspirin’s well-established myriad of side effects, including gastrointestinal and intracerebral haemorrhage. The complex risk–benefit profile of aspirin in general and specific populations is considered in this review.