Aspirin Use and Survival After Diagnosis of Colorectal Cancer

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Abstract
Numerous prospective, observational studies demonstrate that regular aspirin use is associated with a lower risk of colorectal adenoma or cancer.1 In addition, randomized, placebo-controlled trials have shown that use of aspirin,2-5 as well as celecoxib and rofecoxib,6-8 significantly reduces the risk of adenoma among high-risk patients with a prior history of colorectal neoplasia. Aspirin is likely, at least in part, to prevent colorectal neoplasia through inhibition of cyclooxygenase 2 (COX-2), the rate-limiting step for the conversion of arachidonic acid to prostaglandins and related eicosanoids.9,10 COX-2 promotes inflammation and cell proliferation,11 and is overexpressed in the majority of human colorectal cancers.12,13 Overexpression of COX-2 in tumor tissue has been associated with a poorer prognosis among colorectal cancer patients in some13-16 but not all studies.17,18