Colorectal cancer continues to be the third most common form of cancer for both men and women and the second leading cause of cancer death in the United States. Adenomatous polyps are the predisposing lesion in the vast majority of colorectal cancers and 30-50% of Americans over the age of fifty years will develop this type of polyp. It is expected that up to 10% of adenomatous polyps will progress to cancer in a 10 year period. Face with these statistics researchers have been looking for adequate preventive measures. Currently screening colonoscopy performed at set intervals after the age of fifty is the accepted and most recommended means for early detection and prevention of colorectal cancer.

Several studies have shown effectiveness of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs, such as naproxen, ibuprofen, etc.) in reducing the risk of developing adenomatous colonic polyps. The US Preventive Services Task Force (USPSTF) recently released a statement regarding this issue and the study results that led to their recommendation, these where published in the Annals of Internal Medicine of March 6, 2007. Although there is data showing that use of high dose aspirin (325mg daily) for a long period of time (over 10 years) reduce the risk of adenomatous polyp formation it comes at the expense of increase risk gastrointestinal complications, particularly bleeding. Other studies looking at NSAIDs including COX2 inhibitors (such as Celebrex, Vioxx, etc.) also show beneficial effect in reducing risk of adenomatous polyps and even colon cancer it also came at the risk of increasing gastrointestinal, cardiovascular and kidney complications.

In summary the US Preventive Services Task Force recommends against the routine use of aspirin and nonsteroidal anti-inflammatory drugs to prevent colorectal cancer in average risk individuals.

The recommendations need to be individualized and you should discuss your choices with your gastroenterologist since other factors including family history and personal history may weight in the final decision to use these drugs.

For more information visit the official site of USPSTF www.preventiveservices.ahrq.gov