A Randomized Trial of Aspirin to Prevent Colorectal Adenomas in Patients with Previous Colorectal Cancer

In this randomized, double-blind trial, daily ingestion of aspirin reduced the incidence of colorectal polyps among patients with previous colorectal cancer. Of 258 patients in the placebo group who underwent colonoscopy, polyps were found in 70, whereas 43 of 259 patients in the aspirin group were found to have polyps. There is considerable evidence that aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) may decrease the risk of colorectal neoplasia. 1 – 3 Experiments in rodents have demonstrated that indomethacin decreases the incidence of carcinogen-induced colonic tumors, 4 and both retrospective and prospective studies found that NSAIDs protect against colorectal cancer in humans. 5 – 9 Moreover, randomized trials demonstrated a decrease in the number and size of adenomas in patients with familial adenomatous polyposis who received celecoxib or sulindac. 10 , 11 It is difficult to show that NSAIDs prevent colorectal cancer because of the long latency period before cancer develops. Because most colorectal cancers arise from . . .