Aspirin prevents colorectal cancer
The patients at very high genetic risk could benefit.
The hope of a preventive treatment of cancer animates all the researchers but also the people presenting high risks. This is the case of those with Lynch syndrome, a genetic abnormality that significantly increases the risk of cancer, including colorectal but also other organs such as the endometrium. In this rare syndrome, which remains the most common cause of inherited colorectal cancer, patients must undergo colonoscopies at most every two years from the age of 20 years. The goal is of course to detect early colo-rectal cancer that is known to affect more than one of these patients in three.
The study published Friday in the international journal The Lancet, should give some hope to those patients for whom the average age of discovery of colorectal cancer is 42 years (sometimes even before 25 years). This work indeed demonstrates the preventive role of aspirin. In more than 850 people, half taking aspirin and half taking a placebo, it appears that patients who took 600 mg of aspirin daily for 2 years had a reduced risk of colorectal cancer. one third compared to those taking a placebo (inactive product). And that without particular adverse effects. The authors observed 18 cancers for 427 patients in the aspirin group against 30 for 434 patients treated with placebo.
A solid foundation
In 2008, these same researchers had not demonstrated the efficacy of aspirin in this study. It was by prolonging the surveillance of these patients who took aspirin for more than two years that they became aware of the preventive effect of aspirin. After two years, the difference between the two groups began to appear but was still statistically insufficient to draw any conclusions.
Cautious optimism of Dr. David Malka, digestive oncologist at the Institut Gustave-Roussy (Villejuif): "This is a study that could add a new weapon next to the surveillance of patients by colonoscopy," he says. This time, Professor John Burn (Institute of Genetic Medicine, University of Newcastle) and his colleagues are more categorical: "Our results, put in perspective with other recent research, provide a solid basis for recommending aspirin in systematic prevention. in Lynch syndrome, "they write in The Lancet. According to them, what remains is to define the right dose and the right duration of treatment.
Experts are surprised, however, to obtain this result while the number of polyps detected by colonoscopy was identical that patients take aspirin or placebo. The theory is that polyps are the first step before a possible transformation into cancer. Can these results obtained in patients at very high risk, because of their genetic disease, be extrapolated to other categories? What is the benefit / risk ratio of treatment in these cases, because of the risk of bleeding associated with aspirin? For the moment, the results obtained with the low doses of aspirin used in the prevention of recurrence of cardiovascular events, generally less than 100 mg per day, have not shown any interest in reducing the risk of cancer. -rectal. In contrast, for patients with colorectal cancer treated, studies have shown a preventive but moderate effect of aspirin. It is still too early to dare a general recommendation aside from Lynch Syndrome.