Aspirin For The Chemoprevention Of Colorectal Adenomas: A Meta-analysis

Objective:Animal experiments and clinical trails indicate that aspirin has an antineoplastic effect in the large bowel. Randomized clinical trials showed that aspirin reduces the risk of colorectal adenomas, A meta-analysis of these trials will provide more precise estimates of the aspirin effect. Methods:We combined data of all randomized double-blind, placebo-controlled trial that evaluated aspirin for the prevention of colorectal adenomas.search Medline (1966 to 2009) database, OVID (1996 to January 2009) database, Embase (1980 to January 2009) databases, the Chinese Biomedical Literature Database (CBMdisk,1996 to January 2009), and identification of randomized controlled trials (RCT) quality. By Jadad quality score assessed and Rev Man 4.2 software with meta-analysis. Results:five sdudies(four randomized clinical controlled trials,one cohort) were identified, a total of 24.77 thousand cases included in the study. Any dose of aspirin compared with placebo group (P=0.002, Peto OR=0.82,95%CI: 0.72-0.9); high-dose aspirin compared with placebo group(P= 0.006, Peto OR= 0.78, 95%CI:0.65-0.93); low-dose aspirin compared with placebo group (P= 0.05, Peto OR = 0.85,95%CI:0.72-1.00), all could prevent the occurrence of colorectal adenomas. Except the occurrence of stroke was higher in any dose of aspirin compared with placebo group(P=0.00), the risks of adverse reactions were no significant difference in all groups. Conclusion:Aspirin can prevent the occurrence of colorectal adenomas, However, because of its potential risks, it is not used as conventional medicine, There are clinical trials need to further define the optimal dose and duration of treatment of the prophylactic use of Asprin.