U.S. Preventive Services Task Force
Release Date: March 2007
Summary of Recommendation / Supporting Documents
Summary of Recommendation
Rationale
Importance: Colorectal cancer represents the third most common
type of cancer in both men and women and is the second
leading cause of cancer-related deaths in the United States.
Recognition of risk status:
The vast majority of cases of colorectal cancer arise
from adenomatous polyps in average-risk individuals older
than 50 years of age.
Benefits of aspirin and NSAID use:
There is fair to good evidence that aspirin and
NSAIDs, taken in higher doses for longer periods, reduces
the incidence of adenomatous polyps.
There is good evidence that low-dose aspirin does not
lead to a reduction in the incidence of colorectal cancer.
There is fair evidence that aspirin used in doses higher
than those recommended for prevention of cardiovascular
disease and NSAIDs may be associated with a reduction in
the incidence of colorectal cancer.
There is fair evidence that aspirin used over longer
periods may be associated with a reduction in the incidence
of colorectal cancer.
There is poor-quality evidence that aspirin and
NSAID use leads to a reduction in colorectal cancer–associated mortality.
Harms of aspirin and NSAID use:
There is good evidence that aspirin increases the incidence
of gastrointestinal bleeding in a dose-related manner
and fair evidence that aspirin increases the incidence of
hemorrhagic stroke.
There is good evidence that NSAIDs increase the incidence
of gastrointestinal bleeding and renal impairment,
especially in the elderly.
There is good evidence that cyclooxygenase-2 inhibitors,
a class of NSAID, increase the incidence of renal
impairment. Cyclooxygenase-2 inhibitors appear to be associated
with an increased risk for cardiovascular events.
Overall, there is good evidence of at least moderate
harms associated with aspirin and NSAIDs.
USPSTF assessment:
Overall, the USPSTF concluded that harms outweigh
the benefits of aspirin and NSAID use for the prevention
of colorectal cancer.
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Supporting Documents
Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer, March 2007
Recommendation Statement (PDF File, 135 KB; PDF Help)
Aspirin for Primary Prevention of Colorectal Cancer: Systematic Review (PDF File, 300 KB; PDF Help)
Nonsteroidal Anti-inflammatory Drugs and Cyclooxygenase-2 Inhibitors for Primary Prevention of Colorectal Cancer: Systematic Review (PDF File, 330 KB; PDF Help)
Evidence Synthesis (PDF File, 3.6 MB; PDF Help)
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Current as of March 2007
Internet Citation:
Aspirin or Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer, Topic Page. March 2007. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/uspstf/uspsasco.htm
540 Gaither Road Rockville, MD 20850