title: Does aspirin or non-aspirin non-steroidal anti-inflammatory drug use prevent colorectal cancer in inflammatory bowel disease?
abstract: OBJECTIVE
  To determine whether aspirin or non-aspirin non-steroidal anti-inflammatory drugs (NA-NSAIDs) prevent colorectal cancer (CRC) in patients with inflammatory bowel disease (IBD).
  
  
  METHODS
  We performed a systematic review and meta-analysis. We searched for articles reporting the risk of CRC in patients with IBD related to aspirin or NA-NSAID use. Pooled odds ratios (OR) and 95%CIs were determined using a random-effects model. Publication bias was assessed using Funnel plots and Egger's test. Heterogeneity was assessed using Cochran's Q and the I (2) statistic.
  
  
  RESULTS
  Eight studies involving 14917 patients and 3 studies involving 1282 patients provided data on the risk of CRC in patients with IBD taking NA-NSAIDs and aspirin respectively. The pooled OR of developing CRC after exposure to NA-NSAIDs in patients with IBD was 0.80 (95%CI: 0.39-1.21) and after exposure to aspirin it was 0.66 (95%CI: 0.06-1.39). There was significant heterogeneity (I (2) > 50%) between the studies. There was no change in the effect estimates on subgroup analyses of the population studied or whether adjustment or matching was performed.
  
  
  CONCLUSIONS
  There is a lack of high quality evidence on this important clinical topic. From the available evidence NA-NSAID or aspirin use does not appear to be chemopreventative for CRC in patients with IBD.
authors.affiliation: Nick E Burr, Mark A Hull, Venkataraman Subramanian, Leeds Institute for Biomedical and Clinical Sciences, St James's University Hospital, University of Leeds, LS9 7TF Leeds, United Kingdom.
authors.forename: Nick E
authors.initials: NE
authors.lastname: Burr
authors.affiliation: Nick E Burr, Mark A Hull, Venkataraman Subramanian, Leeds Institute for Biomedical and Clinical Sciences, St James's University Hospital, University of Leeds, LS9 7TF Leeds, United Kingdom.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hull
authors.affiliation: Nick E Burr, Mark A Hull, Venkataraman Subramanian, Leeds Institute for Biomedical and Clinical Sciences, St James's University Hospital, University of Leeds, LS9 7TF Leeds, United Kingdom.
authors.forename: Venkataraman
authors.initials: V
authors.lastname: Subramanian
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D016588:Anticarcinogenic Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D016588:Anticarcinogenic Agents; D001241:Aspirin
keywords: Aspirin; Chemoprevention; Colorectal cancer; Inflammatory bowel disease; Non-steroidal anti-inflammatory