USPSTF Recommends Against Routine Aspirin, NSAIDs to Prevent Colorectal Cancer

Individuals with an average risk for colorectal cancer should not take aspirin or nonsteroidal anti-inflammatory drugs, known as NSAIDs, to prevent the disease, says a new recommendation from the U.S. Preventive Services Task Force, or USPSTF. The recommendation and supporting materials are available online.

The recommendation states that although USPSTF members found "fair to good evidence that aspirin and NSAIDs, taken in higher doses for longer periods, reduces the incidence of adenomatous polyps" -- a known precursor to colorectal cancer -- the potential risks of such high-dose, long-term therapy outweighed the likely benefits. Those risks include gastrointestinal bleeding, kidney failure and hemorrhagic stroke. The USPSTF defined a high dose as more than 300 milligrams per day.

"Individuals taking high doses of aspirin or NSAIDs to prevent colorectal cancer should be aware of the potential harms and discuss them with their clinician," said USPSTF Chair Ned Calonge, M.D., in a March 5 press release about the task force's findings. Calonge, a family physician who also is chief medical officer and state epidemiologist for the Colorado Department of Public Health and Information, further noted that patients taking aspirin to prevent other conditions such as heart disease should continue to review the relative benefits of that practice with their clinicians. The USPSTF found good evidence that taking low doses of aspirin (usually less than 100 mg) can reduce cardiovascular risk.

According to the American Cancer Society, colorectal cancer is the third most common type of cancer diagnosed in both men and women in the United States, with 153,760 new cases expected this year. More than 52,000 Americans are expected to die of the disease in 2007.

The USPSTF is an independent panel of experts in primary care and prevention that conducts rigorous reviews of evidence regarding the effectiveness of various clinical preventive services and then develops recommendations based on the results of those reviews. The Agency for Healthcare Research and Quality provides technical and administrative support for the task force.