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Aspirin or NSAIDs for Prevention Of Colorectal Cancer<br />
Title<br />
Population<br />
Recommendation<br />
Routine Aspirin or Nonsteroidal Anti-Inflammatory Drug (NSAID) Use for the Primary Prevention<br />
of Colorectal Cancer<br />
Asymptomatic adults at average risk for colorectal cancer<br />
Do not use aspirin or NSAIDs for the prevention of colorectal cancer.<br />
Grade: D<br />
Risk Assessment<br />
The major risk factors for colorectal cancer are older age (older than age 50 years), family history (having two or more firstor<br />
second-degree relatives with colorectal cancer), and African American race.<br />
10<br />
Balance of Benefits and Harms<br />
Aspirin and NSAIDs, taken in higher doses for longer periods, reduce the incidence of adenomatous polyps. However,<br />
there is poor evidence that aspirin and NSAID use leads to a reduction in colorectal cancer-associated mortality.<br />
Aspirin increases the incidence of gastrointestinal bleeding and hemorrhagic stroke; NSAIDs increase the incidence of<br />
gastrointestinal bleeding and renal impairment, especially in the elderly.<br />
The USPSTF concluded that the harms outweigh the benefits of aspirin and NSAID use for the prevention of colorectal<br />
cancer.<br />
Other Relevant USPSTF<br />
Recommendations<br />
The USPSTF has made recommendations on screening for colorectal cancer and aspirin use for the prevention of<br />
cardiovascular disease. These recommendations are available at http://www.uspreventiveservicestaskforce.org/.<br />
For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents,<br />
please go to http://www.uspreventiveservicestaskforce.org/.
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