Nav: Home

Aspirin to prevent colon cancer underutilized in high-risk patients

February 07, 2019

Colorectal cancer is the third most common cause of cancer deaths in the United States and advanced colorectal polyps are a major risk factor. The U.S. Preventive Services Task Force (USPSTF) concluded that aspirin reduces the risk of colorectal cancer by 40 percent as well as recurrence of advanced polyps. Their guidelines suggest that, without a specific contraindication, health care providers should routinely prescribe aspirin to all patients with advanced colorectal polyps.

To explore whether patients are adhering to these USPSTF recommendations and guidelines, researchers from Florida Atlantic University's Schmidt College of Medicine analyzed data from structured interviews on 84 patients, ages 40 to 91 years old, with biopsy proven advanced colorectal polyps between July 1, 2013 to June 30, 2017.

The data, which were published in the American Journal of Medicine, showed that only 36 (42.9 percent) of the 84 patients with advanced colorectal polyps reported taking aspirin.

"These data indicate underutilization of aspirin to prevent colorectal cancer as well as recurrent polyps in these high risk patients," said Charles H. Hennekens, M.D., Dr.P.H., senior author, the first Sir Richard Doll Professor, and senior academic advisor in FAU's Schmidt College of Medicine.

Co-authors include the first author, Benjamin Fiedler, a senior at Cornell University who has been accepted as a first-year medical student at the Schmidt College of Medicine; Lawrence Fiedler, M.D., a gastroenterologist and affiliate associate professor; Michael DeDonno, Ph.D., assistant professor; Kosi Anago, M.D., a former internal medicine resident; Leonie de la Cruz, a former medical student; and George R. Luck, M.D., associate professor, all in FAU's Schmidt College of Medicine.

"These data pose major challenges that require multifactorial approaches by clinicians and their patients," said Benjamin Fiedler. "These approaches should include therapeutic lifestyle changes, adjunctive drug therapies as well as screening."

Therapeutic lifestyle changes of proven benefit include avoiding and treating overweight and obesity as well as regular physical activity and adjunctive drug therapies including aspirin.

"By utilizing these multifactorial approaches, we believe that these efforts should achieve the most good for the most patients concerning the prevention as well as screening and early diagnosis and treatment of colorectal cancers," said Hennekens, who has done ground-breaking research on the benefits of statins, aspirin, angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs) as well as beta adrenergic blockers -- all of which play major roles in decreasing premature deaths from heart attacks and strokes.

Hennekens was the first to demonstrate that aspirin significantly reduces a first heart attack as well as recurrent heart attacks, strokes, and cardiovascular death when given within 24 hours after onset of symptoms of a heart attack as well as to a wide variety of patients who have survived a blockage in the heart, brain or legs. His landmark and first discoveries on aspirin are not limited to cardiovascular disease and include the prevention of recurrent migraine headaches. He also hypothesized from earlier observational study data that aspirin may decrease risks of colorectal cancer and delay cognitive loss as well as reduce the development of type 2 diabetes. Since then, randomized trials and their meta-analyses have indicated that aspirin prevents colorectal polyps as well as colorectal cancer.

"More than 90 percent of patients diagnosed with colorectal cancer are 50 years or older. The major risk factors are similar to those for heart attacks and stroke and include overweight, obesity as well as physical inactivity, a diet low in fiber and high in fat as well as type 2 diabetes," said Lawrence Fiedler, M.D.

According to the U.S. Centers for Disease Control and Prevention, additional risk factors include inflammatory bowel disease such as Crohn's disease or ulcerative colitis; a personal or family history of colorectal cancer or colorectal polyps; and a genetic syndrome such as familial adenomatous polyposis or hereditary non-polyposis colorectal cancer (Lynch syndrome).
-end-
About the Charles E. Schmidt College of Medicine:

FAU's Charles E. Schmidt College of Medicine is one of approximately 152 accredited medical schools in the U.S. The college was launched in 2010, when the Florida Board of Governors made a landmark decision authorizing FAU to award the M.D. degree. After receiving approval from the Florida legislature and the governor, it became the 134th allopathic medical school in North America. With more than 70 full and part-time faculty and more than 1,300 affiliate faculty, the college matriculates 64 medical students each year and has been nationally recognized for its innovative curriculum. To further FAU's commitment to increase much needed medical residency positions in Palm Beach County and to ensure that the region will continue to have an adequate and well-trained physician workforce, the FAU Charles E. Schmidt College of Medicine Consortium for Graduate Medical Education (GME) was formed in fall 2011 with five leading hospitals in Palm Beach County. In June 2014, FAU's College of Medicine welcomed its inaugural class of 36 residents in its first University-sponsored residency in internal medicine and graduated its first class of internal medicine residents in 2017.

About Florida Atlantic University:

Florida Atlantic University, established in 1961, officially opened its doors in 1964 as the fifth public university in Florida. Today, the University, with an annual economic impact of $6.3 billion, serves more than 30,000 undergraduate and graduate students at sites throughout its six-county service region in southeast Florida. FAU's world-class teaching and research faculty serves students through 10 colleges: the Dorothy F. Schmidt College of Arts and Letters, the College of Business, the College for Design and Social Inquiry, the College of Education, the College of Engineering and Computer Science, the Graduate College, the Harriet L. Wilkes Honors College, the Charles E. Schmidt College of Medicine, the Christine E. Lynn College of Nursing and the Charles E. Schmidt College of Science. FAU is ranked as a High Research Activity institution by the Carnegie Foundation for the Advancement of Teaching. The University is placing special focus on the rapid development of critical areas that form the basis of its strategic plan: Healthy aging, biotech, coastal and marine issues, neuroscience, regenerative medicine, informatics, lifespan and the environment. These areas provide opportunities for faculty and students to build upon FAU's existing strengths in research and scholarship. For more information, visit fau.edu.

Florida Atlantic University

Related Diabetes Articles:

The role of vitamin A in diabetes
There has been no known link between diabetes and vitamin A -- until now.
Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
Two studies in the Jan. 24/31 issue of JAMA find that use of a sensor implanted under the skin that continuously monitors glucose levels resulted in improved levels in patients with type 1 diabetes who inject insulin multiple times a day, compared to conventional treatment.
Complications of type 2 diabetes affect quality of life, care can lead to diabetes burnout
T2D Lifestyle, a national survey by Health Union of more than 400 individuals experiencing type 2 diabetes (T2D), reveals that patients not only struggle with commonly understood complications, but also numerous lesser known ones that people do not associate with diabetes.
Type 2 diabetes and obesity -- what do we really know?
Social and economic factors have led to a dramatic rise in type 2 diabetes and obesity around the world.
A better way to predict diabetes
An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery.
The Lancet Diabetes & Endocrinology: Older Americans with diabetes living longer without disability, US study shows
Older Americans with diabetes born in the 1940s are living longer and with less disability performing day to day tasks than those born 10 years earlier, according to new research published in The Lancet Diabetes & Endocrinology journal.
Reverse your diabetes -- and you can stay diabetes-free long-term
A new study from Newcastle University, UK, has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes.
New cause of diabetes
Although insulin-producing cells are found in the endocrine tissue of the pancreas, a new mouse study suggests that abnormalities in the exocrine tissue could cause cell non-autonomous effects that promotes diabetes-like symptoms.
The Lancet Diabetes & Endocrinology: Reducing sugar content in sugar-sweetened drinks by 40 percent over 5 years could prevent 1.5 million cases of overweight and obesity in the UK and 300,000 cases of diabetes
A new study published in The Lancet Diabetes & Endocrinology journal suggests that reducing sugar content in sugar sweetened drinks (including fruit juices) in the UK by 40 percent over five years, without replacing them with any artificial sweeteners, could prevent 500,000 cases of overweight and 1 million cases of obesity, in turn preventing around 300,000 cases of type 2 diabetes, over two decades.
Breastfeeding lowers risk of type 2 diabetes following gestational diabetes
Women with gestational diabetes who consistently and continuously breastfeed from the time of giving birth are half as likely to develop type 2 diabetes within two years after delivery, according to a study from Kaiser Permanente published today in Annals of Internal Medicine.

Related Diabetes Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".