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Aspirin Not a Substitute for Colorectal Cancer Screening

PHILADELPHIA -- (November 6, 2001) Aspirin is not a cost-effective preventive measure or substitute for colorectal cancer screening tests, a new study finds. Some studies have suggested that aspirin and other non-steroidal anti-inflammatory drugs might reduce risk for colorectal cancer. The study is published in the November 6, 2001, issue of Annals of Internal Medicine.

Researchers at the University of California, San Francisco (UCSF) and the University of Michigan developed a computer simulation based on the natural history of colorectal cancer, performance of three recommended screening tests, and an assumption that aspirin could reduce colorectal cancer death by 30 percent. In various computations of the data, using aspirin actually increased costs and resulted in loss of life-years.

"While aspirin may be of some benefit in colorectal cancer prevention, it should not replace known screening methods," said Uri Ladabaum, MD, MS, assistant professor of gastroenterology at UCSF and lead author of the study.

"In addition, in terms of cost and benefits, it does not make sense for patients already getting regular screening to take aspirin to prevent colorectal cancer. Recommended screening is highly cost-effective and remains so, even in patients already taking aspirin for other reasons like arthritis or prevention of heart disease," Ladabaum said.

"Available screening tests for colorectal cancer are highly effective in detecting disease at a curable stage. Unfortunately, less than half of Americans undergo these life-saving screening examinations as recommended by medical societies," said A. Mark Fendrick, MD, associate professor of medicine at the University of Michigan and the study's senior investigator. "Improving screening rates among adults -- especially those at increased risk for colorectal cancer -- should be the primary goal of a national agenda to prevent colorectal cancer death," Fendrick said.

A video news release on this article will be available on Monday, Nov. 5.

Annals of Internal Medicine, a peer-reviewed medical journal, is published in Philadelphia by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM). ACP-ASIM is the second-largest physician group in the United States, with 115,000 members providing quality health care to adult patients.


Copies of the article, "Aspirin as an Adjunct to Screening for Prevention of Sporadic Colorectal Cancer: a Cost-Effectiveness Analysis," can be obtained by calling the ACP-ASIM Communications Dept. at 1-800-523-1546, ext. 2656.

Dr. Ladabaum can be reached by calling Maureen McInaney at 415-476-2557.

Dr. Fendrick can be reached by calling Susan Quigley at 734-647-9688.

A video news release on this article can be accessed by wire on November 5, embargoed for release until 5 pm ET.

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