Aspirin, Ibuprofen, and the Risk of Colorectal Cancer in Lynch Syndrome

Ouakrim, Driss Ait; Dashti, S. Ghazaleh; Chau, Rowena; Buchanan, Daniel D.; Clendenning, Mark; Rosty, Christophe; Winship, Ingrid; Young, Joanne; Giles, Graham G.; Leggett, Barbara A.; Macrae, Finlay; Ahnen, Dennis J.; Casey, Graham; Gallinger, Steven; Haile, Robert W.; Marchand, Loı̈c Le; Thibodeau, Stephen N.; Lindor, Noralane M.; Newcomb, Polly A.; Potter, John D.; Baron, John A.; Hopper, John L.; Jenkins, Mark A.; Win, Aung Ko

doi:10.1093/jnci/djv170

Cited by 87 publications

(60 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…82,83 In an observational study including 1,858 patients from the Colon Cancer Family Registry who have Lynch syndrome, aspirin use was associated with reduced risk of CRC, for both patients who took aspirin for 5 or more years (HR, 0.25; 95% CI, 0.10-0.62; P=.003) and those who took it for between 1 month and 4.9 years (HR, 0.49; 95% CI, 0.27-0.90; P=.02), compared with those who took aspirin for less than 1 month. 84 At this time, the panel suggests that aspirin may be used to prevent cancer in patients with Lynch syndrome, but it is emphasized that the optimal dose and duration of therapy are currently unknown. The CAPP2 trial used a dose of 600 mg per day, 80 although many clinicians who prescribe daily aspirin as chemoprevention in patients with Lynch syndrome use a lower dose.…”

mentioning

confidence: 99%

Genetic/Familial High-Risk Assessment: Colorectal Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Provenzale¹,

Gupta²,

Ahnen³

et al. 2016

J Natl Compr Canc Netw

Self Cite

200

155

View full text Add to dashboard Cite

OverviewColorectal cancer (CRC) is the fourth most frequently diagnosed cancer and the second leading cause of cancer death in the United States. Abstract This is a focused update highlighting the most current NCCN Guidelines for diagnosis and management of Lynch syndrome. Lynch syndrome is the most common cause of hereditary colorectal cancer, usually resulting from a germline mutation in 1 of 4 DNA mismatch repair genes (MLH1, MSH2, MSH6, or PMS2), or deletions in the EPCAM promoter. Patients with Lynch syndrome are at an increased lifetime risk, compared with the general population, for colorectal cancer, endometrial cancer, and other cancers, including of the stomach and ovary. As of 2016, the panel recommends screening all patients with colorectal cancer for Lynch syndrome and provides recommendations for surveillance for early detection and prevention of Lynch syndrome-associated cancers. J Natl Compr Canc Netw 2016;14(8):1010-1030 NCCN Categories of Evidence and ConsensusCategory 1: Based upon high-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus that the intervention is appropriate. Category 2B: Based upon lower-level evidence, there is NCCN consensus that the intervention is appropriate. Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate. These guidelines are also available on the Internet. For the latest update, visit NCCN.org.

show abstract

mentioning

confidence: 99%

Genetic/Familial High-Risk Assessment: Colorectal Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Provenzale¹,

Gupta²,

Ahnen³

et al. 2016

J Natl Compr Canc Netw

Self Cite

200

155

View full text Add to dashboard Cite

show abstract

“…19 An observational study of patients with Lynch syndrome included in the Colon Cancer Family Registry also showed a reduced risk for colorectal cancer among patients taking aspirin. 20 The ongoing CAPP3 randomized double-blinded trial is evaluating the dose of aspirin needed for chemoprevention in Lynch syndrome (ClinicalTrials.gov identifier: NCT02497820). The prophylactic effect of suppressing inflammation may extend beyond colon cancer to other malignancies such as breast, prostate, and lung cancers.…”

Section: Targeting Inflammation For Cancer Preventionmentioning

confidence: 99%

Functio Laesa: Cancer Inflammation and Therapeutic Resistance

Liu

Kalbasi

Beatty

2017

JOP

View full text Add to dashboard Cite

Tumor, calor, rubor, and dolor describe four cardinal signs of inflammation. The fifth-functio laesa, or loss of function-was promulgated by Rudolf Virchow, who, in the 19th century, also noted an intricate link between inflammation and cancer. However, the role of cancer inflammation in driving loss of therapeutic efficacy has only recently been fully appreciated, as a result of molecular and immunohistochemical approaches applied in clinical medicine and the availability of novel agents for modulating inflammation. This review focuses on clinical evidence from solid malignancies that have shaped our view of how the immune system regulates cancer development, progression, and response to treatment. Understanding the multifaceted relationship between inflammation and patient outcomes has the potential to advance prognostic tools and uncover therapeutic opportunities for improving clinical outcomes.

show abstract

“…The aspirin dose used in this study was 600 mg/day, a dose which is considered difficult to use widely in Japanese patients, who are more susceptible to gastrointestinal disorders caused by aspirin as compared to Europeans and Americans. On the other hand, a study conducted on a large patient cohort, although retrospective, showed the efficacy of aspirin and ibuprofen in preventing the development of colorectal cancer in Lynch syndrome 223) . It remains to be investigated in the future as to what dose and for what duration aspirin should be administered for obtaining this effect.…”

Section: Cq28: Is There Any Chemoprophylaxis That Is Effective In Prementioning

confidence: 99%

Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2016 for the Clinical Practice of Hereditary Colorectal Cancer (Translated Version)

Ishida

Yamaguchi

Tanakaya

et al. 2018

J Anus Rectum Colon

View full text Add to dashboard Cite

Hereditary colorectal cancer accounts for less than 5% of all colorectal cancer cases. Some of the unique characteristics that are commonly encountered in cases of hereditary colorectal cancer include early age at onset, synchronous/metachronous occurrence of the cancer, and association with multiple cancers in other organs, necessitating different management from sporadic colorectal cancer. While the diagnosis of familial adenomatous polyposis might be easy because usually 100 or more adenomas that develop in the colonic mucosa are in this condition, Lynch syndrome, which is the most commonly associated disease with hereditary colorectal cancer, is often missed in daily medical practice because of its relatively poorly defined clinical characteristics. In addition, the disease concept and diagnostic criteria for Lynch syndrome, which was once called hereditary non‐polyposis colorectal cancer, have changed over time with continual research, thereby possibly creating confusion in clinical practice. Under these circumstances, the JSCCR Guideline Committee has developed the “JSCCR Guidelines 2016 for the Clinical Practice of Hereditary Colorectal Cancer (HCRC)," to allow delivery of appropriate medical care in daily practice to patients with familial adenomatous polyposis, Lynch syndrome, or other related diseases. The JSCCR Guidelines 2016 for HCRC were prepared by consensus reached among members of the JSCCR Guideline Committee, based on a careful review of the evidence retrieved from literature searches, and considering the medical health insurance system and actual clinical practice settings in Japan. Herein, we present the English version of the JSCCR Guidelines 2016 for HCRC.

show abstract

Aspirin, Ibuprofen, and the Risk of Colorectal Cancer in Lynch Syndrome

Abstract: Our results provide additional evidence that, for MMR gene mutation carriers, use of aspirin and ibuprofen might be effective in reducing their high risk of colorectal cancer.

Cited by 87 publications

References 59 publications

Genetic/Familial High-Risk Assessment: Colorectal Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Genetic/Familial High-Risk Assessment: Colorectal Version 1.2016, NCCN Clinical Practice Guidelines in Oncology

Functio Laesa: Cancer Inflammation and Therapeutic Resistance

Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2016 for the Clinical Practice of Hereditary Colorectal Cancer (Translated Version)

Contact Info

Product

Resources

About