Long-term aspirin use reduces risk of colorectal cancer, says NICE guidance


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By Anviksha Patel

05 Aug 2019

Aspirin taken daily for a long-term period could reduce the risk of colorectal cancer in patients with an inherited genetic condition, NICE has suggested.

In new draft guidance, NICE has said people with lynch syndrome have an increased risk of developing colorectal cancer, and that taking aspirin on a daily basis for a two-year period could prevent the development.

The main way to detect early colorectal cancer in people with lynch syndrome has until now been through regular screening, with colonoscopy and polypectomy to identify pre-cancerous cells.

In the guidance, it was advised that medical professionals prescribing aspirin to patients with lynch syndrome should follow GMC prescribing guidance as prescribing aspirin in this manner does not have UK market authorisation.

The independent committee made the recommendation based on a randomised trial across multiple countries that showed daily aspirin intake for over two years reduced the risk of developing colorectal cancer.

 

Benefits outweigh potential harms

 

It was stated however, that long-term use of aspirin could result in increased risk of bleeding, but the committee agreed that the benefits outweighed the potential harms.

The committee also said it was not able to recommend a dosage. A typical aspirin dose is either 150mg or 300mg.

The draft NICE guidance states: ’The optimal dose of aspirin that balances the benefits of aspirin as prevention of colorectal cancer and the potential increased bleeding risk, especially with higher doses, remains unclear’.

Colorectal cancer is the fourth most common disease in the UK and the second biggest cancer killer.

The guidance also recommended clinicians consider chemotherapy before surgery for patients with the most severe form of colon cancer, which was based on evidence that it improved survival.

Dr Paul Chrisp, director of the centre for guidelines at NICE, said: ‘The independent committee looked at evidence from a multi-country randomised controlled trial, which showed taking daily aspirin for more than two years reduces the risk of colorectal cancer in people with lynch syndrome.

‘While there are risks associated with long-term aspirin use, the committee agreed that the benefits are likely to outweigh any potential harms.

‘It is important that clinicians and patients discuss the potential harms and benefits of long-term aspirin use so that an informed decision can be made.’


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