Does aspirin reduce the incidence, recurrence, and mortality of colorectal cancer? A meta-analysis of randomized clinical trials.
Level 1 - systematic review of randomized trials
Meta-analysis of randomized controlled trials
PubMed 33594505 · doi:10.1007/s00384-021-03889-8
What was done
Authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of aspirin on colorectal cancer (CRC) incidence, CRC mortality, and colorectal adenoma recurrence. Pooled relative risks (RR) with 95% confidence intervals (CI) were calculated, along with subgroup and sensitivity analyses.
What was found
Aspirin use was not associated with overall CRC incidence (RR 0.97; 95% CI 0.84-1.12; P = 0.66; I2 = 34%). Aspirin was associated with reduced recurrence of colorectal adenomas (RR 0.83; 95% CI 0.72-0.95; P = 0.006; I2 = 63%) and reduced CRC mortality (RR 0.79; 95% CI 0.64-0.97; P = 0.02; I2 = 14%). Subgroup analysis showed a statistically significant association in low-dose aspirin with a pooled RR of 0.85 (95% CI 0.74-0.99; P = 0.03; I2 = 31%).
Why it matters
This review synthesizes trial evidence supporting aspirin's role in reducing adenoma recurrence and CRC mortality, pointing to potential chemopreventive utility particularly at low doses.
Limits
The abstract does not state the number of included RCTs or total participants. High heterogeneity was observed for adenoma recurrence (I2 = 63%), and safety outcomes such as bleeding risk were not reported.
Cited by
- supports Aspirin is used as a repurposed drug to reduce the risk or progression of colon cancer.