Acetylsalicylic Acid in the Prevention of Colorectal Cancer: An Evidence-Based Review

Abstract

INTRODUCTION: The colorectal cancer is one of the main causes of cancer morbimortality in our country. There has been evidence that acetylsalicylic acid has a chemopreventive effect on colorectal cancer. The aim of this study is to review the evidence of acetylsalicylic acid effect on the incidence and mortality of colorectal cancer.
METHODS: A research of systematic reviews, meta-analyzes, randomized clinical trials, cohort studies and clinical guidelines published between 01/06/2010 and 01/06/2020 was done in evidence-based medicine database, with the MeSH terms “Aspirin” “Primary prevention” and “Colorectal neoplasms”. The Strength of Recommendation Taxonomy (SORT) scale of the American Family Physician was used to stratify the studies levels and define their recommendation strength.
RESULTS: It were selected five of 57 articles: a meta-analysis, two systematic reviews, a cohort study, and a clinical guideline. In general, studies have shown that daily doses of 75 mg or more of acetylsalicylic acid for five years or more reduced the colorectal cancer incidence and mortality. However, acetylsalicylic acid should be used with caution due to its increased bleeding risk.
CONCLUSION: The use of acetylsalicylic acid may be effective in reducing colorectal cancer incidence and mortality in adults with medium risk for colorectal cancer with their recommendation strength B (SORT B). Further studies are necessary in order to define the lowest dose and duration of acetylsalicylic acid use that provides an oncological benefit with a lowest bleeding risk.