NICE is recommending that people with Lynch syndrome should be offered daily aspirin for at least two years to prevent colorectal cancer.
The recommendation is included in new draft guidance on the management of colorectal cancer. A multi-centre randomised controlled trial and an observational study have previously reported a reduced risk of colorectal cancer in those taking long-term aspirin.
The NICE guidelines committee was unable to identified any evidence which compared adverse events, such as peptic ulcer, gastrointestinal bleeding or cerebral haemorrhage, in people with Lynch syndrome who took aspirin on a long-term basis, but concluded that the benefits are likely to outweigh any potential harms. However, it recommends that the potential harms and benefits of long-term aspirin use should be discussed so that individuals can make an informed decision.
NICE was unable to recommend a dose, though an ongoing trial is currently studying this.
The draft guidelines also make recommendations on the management of local and metastatic colorectal cancer, and the use of molecular biomarkers to guide systemic anti-cancer therapy.
When finalised, the guideline will replace NICE guidelines CG131 (published November 2011) and CSG5 (published June 2004).