Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) for preventing colorectal cancer and colorectal adenoma in the general population - PubMed
10 hours ago
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- Aspirin's role in preventing colorectal cancer (CRC) remains controversial, balancing uncertain benefits against risks like bleeding.
- Evidence from 10 RCTs (124,837 participants) shows little to no reduction in CRC incidence at 5-<10 years (moderate certainty) and 10-<15 years (moderate certainty), with very low certainty of a slight reduction at ≥15 years.
- CRC mortality may increase with aspirin at 5-<10 years (low certainty), show little difference at 10-<15 years (low certainty), but may decrease at ≥15 years (very low certainty).
- Aspirin probably has little effect on overall serious adverse events but increases serious extracranial hemorrhage (high certainty) and hemorrhagic stroke risk (moderate certainty).
- No RCTs evaluated non-aspirin NSAIDs for primary CRC prevention, and long-term benefits are uncertain due to observational follow-up limitations.
- Clinical practice should focus on individualized risk assessment, weighing cardiovascular benefits against bleeding risks, rather than routine aspirin use for CRC prevention.