The role of aspirin in colorectal cancer chemoprevention.
Considerable interest has emerged over the last decade regarding the role of aspirin in prevention of colorectal cancer. This disease is one of the commonest cancers in the Western World, therefore, the existence of a simple "everyday" agent, which could have the ability to prevent the disease, represents an invaluable opportunity clinicians may be able to exploit. Evidence from case-control and cohort studies, and recent updates of randomised controlled trials have been very encouraging-indicating benefit from long term use of aspirin at low dose. Possible mechanisms of chemoprevention include inhibition of the cyclooxygenase (COX) pathway, or COX-independent mechanisms, for example, the PIK3CA pathway, or therapy-induced senescence of cancer cells. The most serious side effect of prolonged aspirin treatment is haemorrhage, especially from the GI tract. This is likely to be less of a problem with chemoprevention at lower doses. One also needs to consider the impact if aspirin resistance, an increasingly recognised clinical entity.
Upper River Valley Hospital, 11300 Route 130, Waterville, New Brunswick, E7P 0A4, Canada; Dalhousie Medical School, Halifax, Nova Scotia, Canada; Memorial University, St. John's, Newfoundland, Canada. Electronic address: gsinghranger@yahoo.co.uk.
Gurpreet
G
Singh Ranger
D000818:Animals; D001241:Aspirin / Q000627:therapeutic use*; D018890:Chemoprevention; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D064887:Observational Studies as Topic; D016032:Randomized Controlled Trials as Topic
D016861:Cyclooxygenase Inhibitors; D001241:Aspirin
Aspirin; Chemoprevention; Colorectal cancer; Cyclooxygenase-1; Cyclooxygenase-2; Prostaglandins