The effect of aspirin in the recurrence of colorectal adenomas: a meta-analysis of randomized controlled trials
Article first published online: 25 NOV 2008
© 2009 The Authors. Journal Compilation © 2009 The Association of Coloproctology of Great Britain and Ireland
Volume 11, Issue 9, pages 893–901, November 2009
How to Cite
Gao, F., Liao, C., Liu, L., Tan, A., Cao, Y. and Mo, Z. (2009), The effect of aspirin in the recurrence of colorectal adenomas: a meta-analysis of randomized controlled trials. Colorectal Disease, 11: 893–901. doi: 10.1111/j.1463-1318.2008.01746.x
- Issue published online: 12 OCT 2009
- Article first published online: 25 NOV 2008
- Received 30 September 2008; accepted 8 October 2008
- Colorectal adenoma;
Purpose Colorectal adenomas are precursors of most colorectal cancers and are important targets for chemoprevention. Aspirin is thought to play an important role in chemoprevention. However, the role of aspirin in preventing recurrence of adenomas is controversial. We performed a systematic review and meta-analysis to evaluate the effect of aspirin in preventing the recurrence of colorectal adenoma.
Method Trials were located through Medline, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL). From 14 articles screened, three were identified as randomized controlled trials and were included for data extraction. Main outcome measures were the recurrence of any new adenoma and advanced adenoma. The meta-analysis was performed with the fixed-effects model.
Results A total of 2338 participants were enrolled in the three studies and 2175 of them completed the follow-up colonoscopy. We found that the relative risks of any adenoma (when compared with the placebo group) were 0.859 in the high dose of aspirin groups (95% confidence interval (CI), 0.756–0.976, P = 0.019), 0.826 in the low dose of aspirin groups (95% CI 0.706–0.965, P = 0.016) and 0.836 in the both aspirin combined groups (95% CI 0.746–0.937, P = 0.002). For the recurrence of advanced adenoma, the relative risk (when compared with the placebo group) was 0.655 (95% CI 0.513–0.837, P = 0.001) in the aspirin groups without considering the dose.
Conclusion This meta-analysis suggests that aspirin prevents recurrent colorectal adenomas among patients with a history of colorectal adenomas.