- Long-term follow-up shows that aspirin reduces colorectal cancer incidence in Lynch syndrome.
Why this matters
- The authors say there is now a “strong case” for prescribing aspirin to young adults with a germline DNA mismatch repair gene defect.
- ≥10-year follow-up data from a multicenter randomized controlled trial (CAPP2; N=861).
- Participants were randomly assigned to receive daily aspirin (2 doses per day; 300 mg each) or placebo.
- Funding: Cancer Research UK; European Union; Bayer Pharma AG; Barbour Foundation, others.
- At 2 years, there was no significant between-group difference in the frequency of a combined measure including colorectal adenoma and carcinoma formation.
- An intention-to-treat analysis showed a protective effect of aspirin against colorectal cancer (HR, 0.65; P=.035).
- A negative binomial regression that looked at all primary cancer diagnoses in the Lynch syndrome spectrum found a protective effect against cancer (incidence rate ratio, 0.58; P=.0085).
- When the analysis was limited to participants who received aspirin for at least 2 years, the protective effect was similar (HR, 0.56; P=.019).
- The 2 groups had similar frequencies of adverse events.
- Adenoma data are incomplete, forcing the analysis to be restricted to cancer as an endpoint.