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Singh-Ranger. Mini-invasive Surg 2018;2:39 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.23

Opinion Open Access

Aspirin and colorectal cancer chemoprevention

Gurpreet Singh-Ranger 1,2

1 Department of Surgery, Upper River Valley Hospital, New Brunswick E7P 0A4, Canada.
2 Department of Biology, Faculty of Science, Mount Allison University, Sackville, New Brunswick E4L 1E2, Canada.

Correspondence to: Prof. Gurpreet Singh-Ranger, Department of Surgery, Upper River Valley Hospital, 11300 Route 130,
Waterville, New Brunswick E7P 0A4, Canada. E-mail: gsinghranger@yahoo.co.uk

How to cite this article: Singh-Ranger G. Aspirin and colorectal cancer chemoprevention. Mini-invasive Surg 2018;2:39.
http://dx.doi.org/10.20517/2574-1225.2018.23
Received: 9 May 2018 First Decision: 8 Oct 2018 Revised: 5 Nov 2018 Accepted: 5 Nov 2018 Published: 21 Nov 2018

Science Editor: Gordon N. Buchanan Copy Editor: Huan-Liang Wu Production Editor: Cai-Hong Wang

Abstract
The role of aspirin in colorectal cancer prevention is currently under intense scrutiny. Low dose Aspirin effectively
suppresses the cyclooxygenase-2 enzyme system, which is thought to play an important role in the pathogenesis of
colorectal cancer. A number of observational studies and randomized controlled trials have supported a chemoprevention
effect. In some instances, regular use of low dose aspirin has provided a nearly 20% reduction in incidence. Compliance
and underutilization remain important issues however, as does the incidence of side effects - aspirin is a non-steroidal
anti-inflammatory drug, and regular use of these medications carries a small but significant risk of gastrointestinal
bleeding, which on occasion, can be life-threatening. These are important problems, which need wider recognition and
detailed exploration before we can suggest widespread use of aspirin in primary or secondary prevention.

Keywords: Colorectal cancer, adenomas, aspirin, non-steroidal anti-inflammatory drugs, chemoprevention, cyclooxygenase-2

INTRODUCTION
The incidence of rectal cancer has increased over the last decade . Left undiagnosed, patients can present
[1]
with untreatable or stage IV disease, and even when recognised relatively early, cases are often locally
advanced, and require a combination of major surgery, chemotherapy and radiotherapy to attempt cure.

With the advent of laparoscopic, and now robotic resection, the rectal cancer patient is relieved of some of
the discomforts of treatment, but one of the most desired intentions of rectal cancer treatment would be
to prevent or treat the disease at an earlier stage. Most left-sided cancers develop from an earlier adenoma

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
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sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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and indicate if changes were made.

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