A Randomized Trial of Aspirin to Prevent Colorectal Adenomas in Patients with Previous Colorectal Cancer
Autor: | Roger Keresztes, Richard L. Schilsky, John A. Baron, Daniel D. Karp, Susan Budinger, Robert S. Sandler, J. Marc Pipas, Nicholas J. Petrelli, Electra D. Paskett, Charles L. Loprinzi, Gideon Steinbach, Susan Halabi |
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Rok vydání: | 2003 |
Předmět: |
Adenoma
Adult Male Risk medicine.medical_specialty Randomization Colorectal cancer Colonic Polyps Colonoscopy Gastroenterology Disease-Free Survival law.invention Double-Blind Method Randomized controlled trial law Internal medicine Secondary Prevention medicine Humans Aged Aspirin medicine.diagnostic_test business.industry Anti-Inflammatory Agents Non-Steroidal General Medicine Middle Aged medicine.disease Interim analysis Clinical trial Multivariate Analysis Female Colorectal Neoplasms business medicine.drug |
Zdroj: | New England Journal of Medicine. 348:883-890 |
ISSN: | 1533-4406 0028-4793 |
Popis: | Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers.We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas. We randomly assigned 635 patients with previous colorectal cancer to receive either 325 mg of aspirin per day or placebo. We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations. Relative risks were adjusted for age, sex, cancer stage, the number of colonoscopic examinations, and the time to a first colonoscopy. The study was terminated early by an independent data and safety monitoring board when statistically significant results were reported during a planned interim analysis.A total of 517 randomized patients had at least one colonoscopic examination a median of 12.8 months after randomization. One or more adenomas were found in 17 percent of patients in the aspirin group and 27 percent of patients in the placebo group (P=0.004). The mean (+/-SD) number of adenomas was lower in the aspirin group than the placebo group (0.30+/-0.87 vs. 0.49+/-0.99, P=0.003 by the Wilcoxon test). The adjusted relative risk of any recurrent adenoma in the aspirin group, as compared with the placebo group, was 0.65 (95 percent confidence interval, 0.46 to 0.91). The time to the detection of a first adenoma was longer in the aspirin group than in the placebo group (hazard ratio for the detection of a new polyp, 0.64; 95 percent confidence interval, 0.43 to 0.94; P=0.022).Daily use of aspirin is associated with a significant reduction in the incidence of colorectal adenomas in patients with previous colorectal cancer. |
Databáze: | OpenAIRE |
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