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A baby aspirin a day helps to keep adenomas away

Baby aspirin is growing up: It can do more than alleviate pint-sized aches and pains, a DMS team has found. The Dartmouth researchers discovered that 81 milligrams of aspirin a day—the equivalent of one baby tablet— can reduce the risk of developing colon adenomas, benign tumors that can turn cancerous if they're not removed.

Although other clinical trials have shown similar findings, the DMS-led nationwide study was the first to confirm them in a randomized, double-blind study of over 1,100 patients with previously diagnosed adenomas. The results of the seven-year study were published in the New England Journal of Medicine.

John Baron, seated, leads a research group that recently found that a baby aspirin a day may help prevent colon cancer.
Photograph by Mark Austin-Washburn

Neoplasia: "It's fascinating that 'everyday' drugs like calcium and aspirin can reduce the risk of colorectal neoplasia," says John Baron, M.D., who headed the study and also was part of a research team that discovered similar protective benefits from calcium supplements.

Interestingly, the researchers learned that although a baby aspirin provided a protective benefit against adenomas, an adult aspirin—325 milligrams—resulted in little or no benefit. According to Baron, this effect was even more pronounced for advanced adenomas, which have a high tendency to progress to cancer; study participants who took a baby aspirin reduced their rate of polyps by 19% and their risk of the more aggressive adenomas by more than 40%.

The national press leapt on that finding. Although Baron is pleased that the work has been noticed, he worries that the media may misinterpret the results and discourage patients from getting regular colon-cancer screenings. Though he sees positive aspects to the publicity, "on the other hand, I'm worried that the press may get it wrong and end up saying something that will be misleading for the readers.

"For example," Baron says, "if a major newspaper implied that by taking aspirin someone can forget about colorectal screening and follow-up, then it's possible the publicity could cause a net harm." Not only are researchers still debating the appropriate role for aspirin in preventative therapy, he cautions, but patients should always consult their own physicians before starting or changing any medication.

Baron says the team has to conduct more research in order to understand the genetic mechanisms underlying the effect shown by the recent study. They plan to follow its subjects to see if there are delayed effects, and they will also track how long the positive effects last. Finally, they would like to investigate characteristics of the adenomas that do occur to look for molecular clues to the development of colorectal cancer.

Baron and his team want to find answers to still more questions, but the patients who took part in the seven-year study are thrilled with the positive effects they've experienced so far.

Awareness: "Having been diagnosed with polyps, I suddenly became aware of its implications in a way that I otherwise wouldn't have been," explains Janet Mark, a study participant who received aspirin and was polyp-free in her follow-up evaluation. "And, because of that awareness, when the option of becoming a participant in a clinical trial was offered, I was pleased to be a participant. This study will help us all, now and in the future."

Katrina Mitchell

If you would like to offer any feedback about this article, we would welcome getting your comments at DartMed@Dartmouth.edu.

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