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Task Force recommends against use of aspirin and nonsteroidal anti-inflammatory drugs to prevent colorectal cancer

People who are at average risk for colorectal cancer, including those with a family history of the disease, should not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) to try to prevent the disease, according to a new recommendation from the U.S. Preventive Services Task Force. This is the first time the Task Force has made a recommendation related to taking medicines to prevent colorectal cancer. After reviewing the latest evidence on the topic, the Task Force found that the potential harms of taking more than 300 mg per day of aspirin or NSAIDs—which can include increased risks for stroke, intestinal bleeding, or kidney failure—outweigh the potential benefits of colorectal cancer prevention.

Meanwhile, patients taking aspirin to prevent other conditions such as heart disease should continue to discuss the benefits with their clinicians, according to Task Force Chair Ned Calonge, M.D., who is also Chief Medical Officer and State Epidemiologist for the Colorado Department of Public Health and Information. The Task Force found good evidence that taking low doses of aspirin (usually less than 100 mg) can reduce risk for heart disease but does not reduce the rate of colorectal cancer. In 2002, the Task Force strongly recommended that clinicians should screen men and women age 50 and older for colorectal cancer and discuss the use of aspirin as a preventive medication with adults at increased risk for heart disease. Those discussions should address the potential benefits and harms of aspirin therapy.

The Task Force based its conclusions on a report from a research team led by David Moher, M.D., at AHRQ's Evidence-based Practice Center at the University of Ottawa in Canada. The recommendation is published in the March 6, 2007 issue of the Annals of Internal Medicine.

Editor's Note: The U.S. Preventive Services Task Force is an independent panel of experts in prevention and primary care. The Task Force conducts rigorous, impartial assessments of the scientific evidence for the effectiveness of a broad range of clinical preventive services, including screening, counseling, and preventive medications. Its recommendations are considered the gold standard for clinical preventive services. AHRQ provides technical and administrative support, but the recommendations of the panel are its own. Recommendations and materials for clinicians are available on the AHRQ Web site at http://www.ahrq.gov/clinic/uspstfix.htm. Print copies of Task Force recommendations, summaries of the evidence and related materials are also available from AHRQ.

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