Tipping the balance: Benefits and risks of aspirin in chemoprevention of colorectal cancer

Abstract

Convincing evidence now exists to support a clear role for aspirin in the chemoprevention of gastrointestinal malignancies, in particular colorectal cancer. Although much of the data comes from large-scale epidemiological studies, recent randomised controlled trials have added statistically robust evidence to corroborate a beneficial effect of aspirin in the paradigm of chemoprevention, providing a promising avenue for further research into its long-term benefits in this context. The current evidence favours low-dose aspirin: 75-300 mg for 10 years or more in patients at high risk of colorectal cancer is optimal. These putative benefits must be viewed in the light of aspirin's well-established myriad of side effects, including gastrointestinal and intracerebral haemorrhage. The complex risk-benefit profile of aspirin in general and specific populations is considered in this review. © 2013 Springer Science+Business Media New York.