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The prevention effect of aspirin on colorectal cancer in specific populations has been recommended by several guidelines.
, however, there is a lack of evidence for the best age group for preventive drug use, especially for the general population over 70 years of age, after some large trials even suggested the risks of drug use in older populations.
study, led by a Harvard Medical School scholar and published in the Journal of the American Medical Association- Oncology, adds new evidence.
analysis of data from about 95,000 people showed a significantly lower risk of colorectal cancer in people who started taking aspirin before the age of 70 and continued to take it after the age of 70.
study aims to further analyze the association between taking aspirin and the risk of colorectal cancer in older adults.
team compiled data from two large queue studies in the United States - 67,233 women from the Nurses' Health Study (NHS, 1980-2014), an average of 76.4 years, and 27,313 men from the Health Professional Follow-up Study (HPFS, 1986-2014), with an average age of 77.7.
diagnosed with cancer (except melanoma or inflammatory bowel disease) before the start of the study were excluded from this data analysis.
In both groups, people who were still regularly taking aspirin at age 70 and later were usually older, had a history of smoking or were smoking, had colonoscopies, and were more likely to have high blood pressure, diabetes or high blood lipids.
2014 follow-up period, there were 1,431 new cases of colorectal cancer.
other risk factors, the risk of colorectal cancer in older adults who regularly took aspirin after age 70 was significantly reduced by 20 percent compared to unconventional use of aspirin.
, however, the team observed different results by subdividing the age at which aspirin was taken.
The risk was significantly reduced by 20 per cent only in those who started taking aspirin before the age of 70, while in those who took aspirin before the age of 70, there was no statistically significant difference, although a trend of an 8 per cent reduction in the risk of colorectal cancer was shown.
team noted that the findings were consistent after adjusting for antihypertensive medication use, high blood lipids, high blood pressure and cardiovascular disease. The
team said the findings suggest that taking aspirin before the age of 70 could continue to be taken to prevent colorectal cancer, but "the combined ASPREE results do not recommend taking aspirin after age 70 just to prevent colorectal cancer."
, a randomized controlled trial of ASPREE found that aspirin failed to improve the life expectancy of healthy older people (≥70 years old).
after 4.7 years of follow-up, healthy older people who took aspirin had higher mortality rates than the placebo group, and the main reason for the increase was higher cancer deaths.
, low-dose aspirin also increased the risk of severe gastrointestinal bleeding in older adults by 60 percent.
study's lead author, Dr. Andrew T. Chan of Harvard Medical School, and his team identified two potential mechanisms for the effects of different ages on benefits.
On the one hand, there is ample evidence that aspirin needs to be taken for at least 5-10 years to show benefits in preventing colorectal cancer, and the available data on aspirin for colorectal cancer prevention are derived mainly from studies conducted in middle-age people.
For example, the CAPP2 trial, published last year in The Lancet, found that taking aspirin in early adulthood (average age 45) halved the risk of colorectal cancer over the next 10-20 years, but the preventive effects took years to manifest.
, on the other hand, the lack of effectiveness in taking aspirin preventively in old age has a biologically sound basis: the pathogenesis of cancer in older adults may be different than in older adults.
, for example, is associated with changes in DNA methylation, which can affect cancer susceptivity.
, for example, colorectal cancer is more common on the right side of the colon in older adults, and tumor-specific molecular changes such as BRAF mutations occur more frequently.
Brooks D. Cash, director of the Department of Gastroenterology, Hepatology and Nutrition at the University of Texas Health Science Center, commented that in other studies, aspirin has shown benefits in reducing colorectal cancer and has benefited from longer doses.
analysis seems to confirm these observations.
But he added that these findings should not be understood as a full and effective prevention of colorectal cancer through aspirin alone, but rather as a focus on healthy eating, maintaining a healthy weight, avoiding smoking, and regular colorectal cancer screening (e.g. fecal blood tests and colonoscopies).
, on the other hand, "we don't have an answer at what age we should stop taking aspirin to prevent colorectal cancer."
team acknowledges that while both team studies are conducted among trained healthcare professionals, there are limitations to post-observational research.
, it is still necessary to further clarify the biological mechanisms of aspirin in people of different ages in the future.
, the U.S. Preventive Services Working Group (USPSTF) recommends taking small doses of aspirin to prevent colorectal cancer in patients with a 10-year risk of cardiovascular disease greater than 10 percent.
also have several international guidelines recommending that people with Lynch syndrome consider taking aspirin to prevent colorectal cancer.
The China Guidelines for Colorectal Cancer Screening and Early Diagnosis and Treatment (2020) suggest that evidence from group Chinese also confirms that taking aspirin is a protective factor for colorectal cancer, but considering the risk of medication, the use of aspirin in the prevention of colorectal cancer in the first level needs to be carried out under the guidance of a professional physician.
more evidence to provide more insight into aspirin's "precision cancer prevention."
aspirin for colorectal cancer prevention in specific populations has been recommended by several guidelines.
, however, there is a lack of evidence for the best age group for preventive drug use, especially for the general population over 70 years of age, after some large trials even suggested the risks of drug use in older populations.
study, led by a Harvard Medical School scholar and published in the Journal of the American Medical Association- Oncology, adds new evidence.
analysis of data from about 95,000 people showed a significantly lower risk of colorectal cancer in people who started taking aspirin before the age of 70 and continued to take it after the age of 70.
study aims to further analyze the association between taking aspirin and the risk of colorectal cancer in older adults.
team compiled data from two large queue studies in the United States - 67,233 women from the Nurses' Health Study (NHS, 1980-2014), an average of 76.4 years, and 27,313 men from the Health Professional Follow-up Study (HPFS, 1986-2014), with an average age of 77.7 years.
people diagnosed with cancer (except melanoma or inflammatory bowel disease) before the start of the study were excluded from this data analysis.
In both groups, people who were still regularly taking aspirin at age 70 and later were usually older, had a history of smoking or were smoking, had colonoscopies, and were more likely to have high blood pressure, diabetes or high blood lipids.
2014 follow-up period, there were 1,431 new cases of colorectal cancer.
other risk factors, the risk of colorectal cancer in older adults who regularly took aspirin after age 70 was significantly reduced by 20 percent compared to unconventional use of aspirin.
, however, subdivided the age at which aspirin was taken, and the team observed different results.
The risk was significantly reduced by 20 per cent only in those who started taking aspirin before the age of 70, while in those who took aspirin before the age of 70, there was no statistically significant difference, although a trend of an 8 per cent reduction in the risk of colorectal cancer was shown.
team noted that the findings were consistent after adjusting for antihypertensive medication use, high blood lipids, high blood pressure and cardiovascular disease. The
team said the findings suggest that taking aspirin before the age of 70 could continue to be taken to prevent colorectal cancer, but "the combined ASPREE results do not recommend taking aspirin after age 70 just to prevent colorectal cancer."
, a randomized controlled trial of ASPREE found that aspirin failed to improve the life expectancy of healthy older people (≥70 years old).
after 4.7 years of follow-up, healthy older people who took aspirin had higher mortality rates than the placebo group, and the main reason for the increase was higher cancer deaths.
, low-dose aspirin also increased the risk of severe gastrointestinal bleeding in older adults by 60 percent.
study's lead author, Dr. Andrew T. Chan of Harvard Medical School, and his team identified two potential mechanisms for the effects of different ages on benefits.
On the one hand, there is ample evidence that aspirin needs to be taken for at least 5-10 years to show benefits in preventing colorectal cancer, and the available data on aspirin for colorectal cancer prevention are derived mainly from studies conducted in middle-age people.
For example, the CAPP2 trial, published last year in The Lancet, found that taking aspirin in early adulthood (average age 45) halved the risk of colorectal cancer over the next 10-20 years, but the preventive effects took years to manifest.
, on the other hand, the lack of effectiveness in taking aspirin preventively in old age has a biologically sound basis: the pathogenesis of cancer in older people may be different than in older people.
, for example, is associated with changes in DNA methylation, which can affect cancer susceptivity.
, for example, colorectal cancer is more common in older people on the right side of the colon, and tumor-specific molecular changes such as BRAF mutations occur more frequently.
Brooks D. Cash, dean of the Department of Gastroenterology, Hepatology and Nutrition at the University of Texas Health Science Center, commented that in other studies, aspirin has shown benefits in reducing colorectal cancer and has benefited from longer doses.
this analysis seems to confirm these observations.
But he added that these findings should not be understood as a full and effective prevention of colorectal cancer through aspirin alone, but rather as a focus on healthy eating, maintaining a healthy weight, avoiding smoking, and regular colorectal cancer screening (e.g. fecal blood tests and colonoscopies).
, on the other hand, "we don't have an answer at what age we should stop taking aspirin to prevent colorectal cancer."
team acknowledges that while both team studies are conducted among trained healthcare professionals, there are limitations to post-observational research.
, it is still necessary to further clarify the biological mechanisms of aspirin in people of different ages in the future.
, the U.S. Preventive Services Working Group (USPSTF) recommends taking small doses of aspirin to prevent colorectal cancer in patients with a 10-year risk of cardiovascular disease greater than 10 percent.
also have several international guidelines recommending that people with Lynch syndrome consider taking aspirin to prevent colorectal cancer.
The China Guidelines for Colorectal Cancer Screening and Early Diagnosis and Treatment (2020) suggest that evidence from group Chinese also confirms that taking aspirin is a protective factor for colorectal cancer, but considering the risk of medication, the use of aspirin in the prevention of colorectal cancer in the first level needs to be carried out under the guidance of a professional physician.
more evidence to provide more insight into aspirin's "precision cancer prevention."