Prevention by aspirin of colorectal adenoma recurrence: Some advances and latest results of the APACC trial

Current Colorectal Cancer Reports

Volumn 7, Issue 1, 2011, Pages 33-41

  Benamouzig, Robert ^c   Uzzan, Bernard ^a   Deyra, Jacques ^b   Martin, Antoine ^a   Chaussade, Stanislas ^b  

^a AVICENNE HOSPITAL   (France)

^b Institut Cochin   (France)

^c NONE

Author keywords

Acetylsalicylic acid; Chemoprevention; Colorectal adenoma; COX 2 expression; Placebo; Randomized controlled trial

Indexed keywords

ACETYLSALICYLIC ACID; CYCLOOXYGENASE 2;

ADENOMATOUS POLYP; BLEEDING; CANCER RECURRENCE; CANCER RISK; COLONOSCOPY; COLORECTAL ADENOMA; DYSPLASIA; HUMAN; IMMUNOHISTOCHEMISTRY; META ANALYSIS; NONHUMAN; PROTEIN EXPRESSION; RANDOMIZED CONTROLLED TRIAL (TOPIC); RECURRENCE RISK; REVIEW; STROKE; SYSTEMATIC REVIEW; TUMOR VOLUME; UNSPECIFIED SIDE EFFECT;

EID: 79952707800     PISSN: 15563790     EISSN: 15563804     Source Type: Journal    
DOI: 10.1007/s11888-010-0079-5     Document Type: Review

References (34)

1. IARC Working Group on the Evaluation of Cancer Preventive Agents. Non-Steroidal Anti-Inflammatory Drugs. Lyon, International Agency for Research on Cancer. World Health Organization, 1997.
2. La Vecchia C, Negri E, Franceschi S, et al. Aspirin and colorectal cancer. Br J Cancer 1997; 76: 675-7. (Pubitemid 27354684)
3. Neugut AI, Rosenberg DJ, Ahsan H, et al. Association between coronary heart disease and cancers of the breast, prostate and colon. Cancer Epidemiol Biomarkers Prev 1998; 7: 869-873 (Pubitemid 28471574)
4. Smalley W, Ray WA, Daugherty J, Griffin MR. Use of nonsteroidal anti-inflammatory drugs and incidence of colorectal cancer: a population-based study. Arch Intern Med 1999; 159: 161-166 (Pubitemid 29055104)
5. Collet JP, Sharpe C, Belzile E, et al. Colorectal cancer prevention by non-steroidal anti-inflammatory drugs: effects of dosage and timing. Br J Cancer 1999; 81: 62-68. (Pubitemid 29415492)
6. Langman MJ, Cheng KK, Gilman EA, Lancashire RJ. Effect of anti-inflammatory drugs on overall risk of common cancer: case-control study in general practice research database. Br Med J 2000; 320: 1642-6. (Pubitemid 30364636)
7. Coogan PF, Rosenberg L, Louik C, et al. NSAIDs and risk of colorectal cancer according to presence or absence of family history of the disease. Cancer Causes Control 2000; 11: 249-55. (Pubitemid 30182142)
8. Kune GA, Kune S, Watson LF. Colorectal cancer risk, chronic illness, operations and medications: case-control results from the Melbourne Colorectal Cancer Study. Cancer Res 1998; 48: 4399-4404.
9. Giovannucci E, Rimm EB, Stampfer MJ, et al. Aspirin use and the risk for colorectal cancer adenoma in male health professionals. Ann Intern Med 1994; 121: 241-6. In a large cohort, aspirin decreased the risk of colorectal cancer.
10. Giovannucci E, Egan KM, Hunter DJ, et al. Aspirin and the risk of colorectal cancer in women. N Engl J Med 1995; 333: 609-14. In the Nurses Health Study aspirin decreased the risk of colorectal cancer.
11. Muller AD, Sonnenberg A, Wasseman IH. Diseases preceeding colon cancer. A case control study among veterans. Dig Dis Sci 1994; 39: 2480-4.
12. Peleg II, Maibach HT, Brown SH, Wilcox CM. Aspirin and nonsteroidal anti-inflammatory drug use and the risk of subsequent colorectal cancer. Arch Intern Med 1994; 154: 394-9. (Pubitemid 24072212)
13. Chan AT, Giovannucci EL, Meyerhardt JA, et al. Long-term use of aspirin and nonsteroidal anti-inflammatory drugs and risk of colorectal cancer. JAMA 2005; 294: 914-923. In the large Nurses' Health Study cohort, aspirin decreased the risk of colorectal cancer.
14. Cook NR, Lee IM, Gaziano JM, et al. Low-dose aspirin in the primary prevention of cancer: the Women's Health Study: A randomised controlled trial. JAMA 2005; 294: 47-55. (Pubitemid 41002838)
15. Chan AT, Ogino S, Fuchs CS. Aspirin use and survival after diagnosis of colorectal cancer. JAMA 2009; 302: 649-659. This article shows that regular aspirin use after colorectal cancer is associated with lower risk of cancer-specific and overall mortality, especially for tumors overexpressing COX-2.
16. Dubé C, Rostom A, Lewin G, et al. The use of aspirin for primary prevention of colorectal cancer: A systematic review prepared for the US preventive services task force. Ann Intern Med 2007; 146: 365-375. (Pubitemid 351650597)
17. Benamouzig R. Do aspirin or nonsteroidal anti-inflammatory drugs decrease the risk of colorectal cancer?. Gastroenterol Clin Biol 1998; 22: S22-7.
18. Gann PH, Manson JE, Glynn RJ, et al. Low-dose aspirin use and incidence of colorectal tumors in a randomised trial. J Natl Cancer Instit 1993; 85: 1120-24.
19. Sturmer T, Glynn RJ, Lee IM, et al. Aspirin use and colorectal cancer: post-trial follow-up data from the Physicians' Health Study. Ann Intern Med 1998; 128: 713-20. (Pubitemid 28204862)
20. Sandler RS, Halabi S, Baron JA, et al. A randomized trial of aspirin to prevent colorectal adenomas in patients with previous colorectal cancer. N Engl J Med 2003; 348: 883-890. Erratum in N Engl J Med 2003; 348: 1939. Daily use of aspirin (325 mg/d) reduced the incidence of adenomas.
21. Baron JA, Cole BF, Sandler RS, et al. A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med 2003; 348: 891-899. (Pubitemid 36297997)
22. Logan RF, Grainge MJ, Shepherd VC, Armitage NC, Muir KR, ukCAP Trial Group. Aspirin and folic acid for the prevention of recurrent colorectal adenomas. Gastroenterology 2008; 134: 29-38. This randomized controlled trial using a 2x2 factorial design showed that aspirin (300 mg/d) but not folate reduced colorectal adenoma recurrence.
23. Flossmann E, Rothwell PM, on behalf of the British Doctors Aspirin Trial and the UK-TIA Aspirin Trial. Effect of aspirin on long-term risk of colorectal cancer: consistent evidence from randomised and observational studies. Lancet 2007; 369: 1603-1613.
24. Giardiello FM, Yang VW, Hylind LM, et al. Primary chemoprevention of familial adenomatous polyposis with sulindac. N Engl J Med 2002; 346: 1054-1059. Standard doses of sulindac did not prevent the occurrence of adenomas in this randomized placebo-controlled trial.
25. Steinbach G, Lynch PM, Phillips RKS, et al. The effect of celecoxib, a cyclooxygenase-2 inhibitor, in familial adenomatous polyposis. N Engl J Med 2000; 342: 1946-1952. In this randomized placebo-controlled trial, celecoxib (100 or 400 mg twice daily) reduced the number of colorectal polyps.
26. Arber N, Eagle CJ, Spicak J, et al. Celecoxib for the prevention of colorectal adenomatous polyps. N Engl J Med 2006; 355: 885-895. Celecoxib (400 mg/d) reduced the occurence of adenomas within 3 years after polypectomy.
27. Baron JA, Sandler RS, Bresalier RS, et al. A randomized trial of rofecoxib for the chemoprevention of colorectal adenomas. Gastroenterology 2006; 131: 1674-1682. Rofecoxib (25 mg/d) compared with placebo reduced the risk of adenomas but with serious toxicity.
28. Bertagnolli M, Eagle CJ, Zauber AG, et al. Celecoxib for the prevention of sporadic colorectal adenomas. N Engl J Med 2006; 355: 873-884. In this randomized placebo-controlled trial, celecoxib (200 or 400 mg twice daily) reduced the risk of adenomas.
29. Chan AT, Ogino S, Fuchs CS. Aspirin and the risk of colorectal cancer in relation to the expression of COX-2. N Engl J Med 2007; 356: 2131-2142. This article suggests the role of COX-2 expression in aspirin's preventive effect.
30. Benamouzig R, Deyra J, Martin A, et al. Daily soluble aspirin and prevention of colorectal adenoma recurrence: One-year results of the APACC trial. Gastroenterology 2003; 125: 328-336. (Pubitemid 36929412)
31. Benamouzig R, Yoon H, Little J, et al. APACC, a French prospective study on aspirin efficacy in reducing colorectal adenoma recurrence: design and baseline findings. Eur J Cancer Prev 2001; 10: 327-335 (Pubitemid 32735349)
32. Benamouzig R, Uzzan B, Martin A, et al. Cyclooxygenase-2 expression and recurrence of colorectal adenomas: effect of aspirin chemoprevention. Gut 2010; 59: 622-629. This article describes the pathological findings of the APACC trial: overexpression of COX-2 predominating in large and high-grade dysplasia adenomas; deep stromal but not epithelial initial expression of COX-2 predicting adenoma recurrence; and aspirin not acting preferentially on patients whose initial adenomas strongly expressed COX-2.
33. Burn J, Bishop DT, Mecklin JP, et al. Effect of aspirin or resistant starch on colorectal neoplasia in the Lynch syndrome. N Engl J Med 2008; 359: 2567-2578
34. Cole BF, Logan RF, Halabi S, et al. Aspirin for the chemoprevention of colorectal adenomas: meta-analysis of the randomized trials. J Natl Cancer Inst 2009; 101: 256-266. This article is a patient-based meta-analysis of all four randomized placebo-controlled trials of secondary prevention of colon adenomas by aspirin, showing its effectiveness.