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Gastrointestinal Cancers
Symposium (ASCO GI) 2017
19–21 JANUARY 2017 | SAN FRANCISCO, CALIFORNIA
Top research at this
year’s 2017 GI Cancers
Symposiumwith the
theme
Multidisciplinary
Precision Care: Progress
and Innovation
, showcased
targeted therapies as
a promising option
in difficult-to-treat
patient populations
with limited treatment
options, the potential
of immunotherapy and
novel applications of
existing diagnostic and
therapeutic tools.
Long-termuse of low-dose aspirin helps prevent colorectal cancer,
but raises GI bleeding risk
L
ong-term use of low-dose aspirin has
been shown to help prevent colorectal
cancer, but also raises gastrointestinal
bleeding risk, report results of a retrospective,
population-based cohort evaluation.
Joseph J.Y. Sung, SBS, JP, of the Chinese Uni-
versity of Hong Kong, explained that aspirin
is commonly used to help prevent cardiovas-
cular and cerebrovascular disease, and is well
known to protect against colorectal cancer.
Aspirin is also known, however, to raise the
risk of gastrointestinal bleeding.
Few large-scale studies have compared the
benefit and risk of long-term aspirin use.
Dr Sung set out to evaluate the use of low-
dose aspirin to prevent colorectal cancer and
the risk of gastrointestinal bleeding associated
with its use.
The incidence and mortality of colorectal
cancer and gastrointestinal bleeding was
assessed in a population of 689,209 persons.
A total of 206,243 patients taking low-dose
aspirin were compared with 482,966 sex-and
age-matched controls in a 1:2 ratio.
Patients who had been taking aspirin
≤
6 months were excluded. Aspirin users had
been taking a mean dose of 80 mg daily for
a mean duration of 7.7 years. All included
persons must have had at least 10 years of
follow-up on their clinical outcome.
Among aspirin users, 5776 (2.80%) were
diagnosed with colorectal cancer and 2097
(1.02%) died of the malignancy. A total of
16,483 (3.41%) nonusers were diagnosed
with colorectal cancer; 7963 (1.65%) died
of the disease.
Using Cox proportional hazard regression,
aspirin use showed a modest but significant
reduction in colorectal cancer mortality (haz-
ard ratio 0.65; 95% CI 0.62–0.69).
On the other hand, 11,187 (5.42%) aspirin
users developed gastrointestinal bleeding, and
841 died (0.41%). A total of 15,186 nonusers
(3.14%) developed gastrointestinal bleeding,
and 1682 patients (0.35%) died.
Aspirin users showed modest but significant
increased risk of gastrointestinal bleed-related
mortality (HR 1.24; 95% CI 1.14–1.35).
Dr Sung concluded that long-term use of low-
dose aspirin helps prevent colorectal cancer,
but also raises associated gastrointestinal
bleed risk. Considerations of prophylactic use
of aspirin should balance the benefit and the
risk of this treatment to the target population.
PracticeUpdate Editorial Team
CONFERENCE COVERAGE
18
PRACTICEUPDATE HAEMATOLOGY & ONCOLOGY