Long-Term Aspirin Use Seems to Protect Against Colorectal Lesions

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Patients who'd initially been assigned to low-dose aspirin in the first trial and continued to take the drug on a "frequent" basis had a 13 percent lower risk for developing precancerous lesions (known as colorectal adenomas), compared with those who had initially taken a placebo and then went on to use NSAIDs "sporadically." The risk difference between the two groups was approximately 27 percent versus 40 percent, the study found.

The researchers also saw a similar risk spread between "sporadic" and "frequent" users of higher-dose (325 mg) aspirin, but they said the difference did not appear statistically significant.

The researchers also noted that the protective benefit of aspirin for a few years appeared to continue for some time among those who stopped taking the drug.

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Baron cautioned, however, that NSAID drugs such as aspirin should be taken advisedly because of the gastro-intestinal side effects.

"It's a genuine concern. And that leads to the issue that for any drug or any intervention, you have to consider all the possible outcomes, good and bad, that may ensue," he said.

"Aspirin, for example, has a lot of benefits," Baron added. "It reduces the risk for cardiovascular disease, certainly among people who have had a history of previous stroke or heart attack. But aspirin, like all the NSAIDs, has the problem of prompting GI bleeding and GI heartburn, and also infrequently ulcers.

But Dr. Jerald D. Wishner, director of colon and rectal surgery at Northern Westchester Hospital Center in Mount Kisco, N.Y., said high-risk patients shouldn't turn to NSAIDs instead of routine screenings, such as a colonoscopy.

"I think it is appropriate to recommend NSAIDs to our patients, because if I can reduce the risk by 10 to 15 percent, and all it involves is taking an aspirin a day, who wouldn't sign up for that?" he said. "But we're talking about a high-risk group here. So, at the same time, we have to advise these patients that they are still at a higher risk and recommend that they continue to come in for follow-up screenings as they would if they weren't talking the aspirin."

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