Downing, A., Fenton, H., Nickerson, C. et al. (6 more authors) (2023) Colorectal polyp outcomes after participation in the seAFOod polyp prevention trial: evidence of rebound elevated colorectal polyp risk after short-term aspirin use. Alimentary Pharmacology & Therapeutics, 58 (6). pp. 562-572. ISSN 1365-2036
Abstract
Background The seAFOod polyp prevention trial was a randomised, placebo-controlled, 2 × 2 factorial trial of aspirin 300 mg and eicosapentaenoic acid (EPA) 2000 mg daily in individuals who had a screening colonoscopy in the English Bowel Cancer Screening Programme (BCSP). Aspirin treatment was associated with a 20% reduction in colorectal polyp number at BCSP surveillance colonoscopy 12 months later. It is unclear what happens to colorectal polyp risk after short-term aspirin use.
Aim To investigate colorectal polyp risk according to the original trial treatment allocation, up to 6 years after trial participation.
Methods All seAFOod trial participants were scheduled for further BCSP surveillance and provided informed consent for the collection of colonoscopy outcomes. We linked BCSP colonoscopy data to trial outcomes data.
Results In total, 507 individuals underwent one or more colonoscopies after trial participation. Individuals grouped by treatment allocation were well matched for clinical characteristics, follow-up duration and number of surveillance colonoscopies. The polyp detection rate (PDR; the number of individuals who had ≥1 colorectal polyp detected) after randomization to placebo aspirin was 71.1%. The PDR was 80.1% for individuals who had received aspirin (odds ratio [OR] 1.13 [95% confidence interval 1.02, 1.24]; p = 0.02). There was no difference in colorectal polyp outcomes between individuals who had been allocated to EPA compared with its placebo (OR for PDR 1.00 [0.91, 1.10]; p = 0.92).
Conclusion Individuals who received aspirin in the seAFOod trial demonstrated increased colorectal polyp risk during post-trial surveillance. Rebound elevated neoplastic risk after short-term aspirin use has important implications for aspirin cessation driven by age-related bleeding risk. ISRCTN05926847.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. https://creativecommons.org/licenses/by/4.0/ |
Keywords: | Digestive Diseases; Cancer; Colo-Rectal Cancer; Prevention; Clinical Research; Clinical Trials and Supportive Activities; Aging; Evaluation of treatments and therapeutic interventions; Nutrition and chemoprevention; Prevention of disease and conditions, and promotion of well-being; Pharmaceuticals; Cancer; Oral and gastrointestinal |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > Department of Oncology (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 07 Aug 2023 14:05 |
Last Modified: | 09 Oct 2024 14:51 |
Status: | Published |
Publisher: | Blackwell Publishing |
Refereed: | Yes |
Identification Number: | 10.1111/apt.17646 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202163 |