Sociologists are interested in identifying how change is initiated; for what or whose purposes and with what consequences. While some aspects of social change create positive results for instance, democracy and human rights expanded in the aftermath of the American and French revolutionsmany have unintended consequences for instance, the expanded availability of communications technology blurs conventional boundaries between home and work.
Research Aspirin to Reduce Cancer Risk Aspirin may reduce the risk of colorectal cancer and researchers are studying whether it reduces the risk of other cancers.
But studies over the last two decades have suggested that regular use of aspirin may have another important benefit: Results from some of these studies, in fact, formed the basis for guidance released in April by an influential federal advisory panel on disease prevention.
The panel, the U. Preventive Services Task Force USPSTFrecommended that, for some people, aspirin can be used to help reduce their risk of cardiovascular disease and colorectal cancer. And researchers are continuing to investigate critical questions, including just how aspirin may reduce colorectal cancer risk and what other cancers, if any, regular use of this century-old drug may help to prevent.
The findings from these studies should help to fill an important informational void. But the evidence also extends to those at average colorectal cancer risk as well.
Among the most recent examples is an analysis of two large, long-running cohort studies published in June in JAMA Oncology. The study, led by Dr. And several randomized clinical trials have shown Several research questions on the causes aspirin use "at any dose" can reduce the incidence of any polyps as well as advanced polyps, he said, both of which can be precursors to colorectal cancer.
The recommendation also advises that potential candidates should have a life expectancy of at least 10 years and not be at increased risk of bleeding due to other health conditions or the use of other medications —a known side effect of long-term aspirin use.
The June Harvard study also revealed another important finding that should help to clarify a point of debate among prevention researchers, Dr.
In people who had been screened for colorectal cancer, regular aspirin use produced an added reduction in risk.
The latter refers to cancers that are diagnosed in the interval after a normal screening exam and before the next scheduled screening. Reduced Risk of Other Cancers?
The jury is still out on whether aspirin has a future as a way to reduce the risk of cancers other than colorectal. Findings that regular aspirin use is associated with a reduced risk of other cancers "have been hit or miss," Dr.
In the recent Harvard study, for instance, aspirin use was not linked with a reduced risk of the other most common cancers.
And for colorectal cancer prevention, there is also evidence from clinical trials and laboratory experiments to support its use. Many studies of aspirin and cancer risk often have important limitations, Dr. Brasky said, including missing information on critical factors like aspirin dose and duration of use.
Other studies have identified other factors that may predict who is likely to benefit, factors that hint at the molecular mechanisms by which aspirin may exert its anticancer effects. Prolonged inflammation can promote changes in cells that can cause them to become malignant. This appears to be particularly true in colorectal cancer, where inflammation can promote changes in the cells that line the lower gastrointestinal tract, leading to the formation of precancerous growths.
These studies have allowed researchers to home in on key players in this inflammatory cascade, changes which may be markers of cancer risk. For example, a series of studies from researchers at Harvard and Dana-Farber Cancer Institute—using the same large cohorts as the June JAMA Oncology study—have pointed to specific biological factors that may influence its preventive potential.
One of their earlier studiesfor example, showed that aspirin use appeared to only reduce the risk of colorectal cancers that produced large amounts of COX More recent studies have zeroed in on other components of the COX-2 pathway, including one study that showed that aspirin reduced colorectal cancer risk only in people whose colonic mucosa—the cell layer that lines the colon—overexpressed the gene PGDH, which encodes for an enzyme that disrupts COX-2 activity.
Although these potential biomarkers have not been validated, they start to show how, eventually, decisions about the use of aspirin to reduce cancer risk may potentially be tailored to individual patients, Dr. That research should help to better clarify who might benefit from aspirin, Dr.
Clinical trials will be crucial in this regard, explained Asad Umar, D.
Umar cited the experience with celecoxib. Evidence of adverse cardiac effects from regular long-term treatment with this drug only emerged when it was tested in large trials with longer patient follow-up, including the NCI-funded Adenoma Prevention with Celecoxib trial.
The chief concern with aspirin is gastrointestinal bleeding. The available data from clinical trials on longer-term aspirin use, however, suggests that this risk may be modest.
In the eight trials included in an influential meta-analysis which found that regular aspirin use reduced the risk of dying from cancer, for example, there were more fatal bleeding events among participants who took a placebo than among those who took aspirin, although aspirin did increase the risk of nonfatal bleeding.
And in the CAPP2 trial, the number of cases of gastrointestinal bleeding in the aspirin group and placebo groups were very similar. Included among them are: CAPP3a follow-on study from CAPP2 that is testing three different aspirin doses in patients with Lynch syndrome; ASPREEwhich is testing whether low-dose aspirin can reduce the risk of cancer, heart attack, stroke, or dementia in people aged 65 and older; and Add-Aspirinwhich is examining two different doses of aspirin as an adjuvant treatment for people who have undergone surgery for early-stage breast, colorectal, prostate, or esophageal cancer.
These long-term studies, Dr. Umar stressed, "are needed to answer many important questions. February 23, If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. All comments must follow our comment policy.Read this History Other Essay and over 89, other research documents.
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