ASPİRİN BAĞIRSAK KANSERİNE BAĞLI ÖLÜMÜ AZALTIYOR
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ASPİRİN BAĞIRSAK KANSERİNE BAĞLI ÖLÜMÜ AZALTIYOR Özel


-Daha önce Annals of Oncology dergisinde çıkan metaanalizde, 50-70 yaş arası, en az 5 yıl süreyle aspirin kullananlarda, kolon, mide, yemek borusu kanserlerine bağlı ölümlerde %30-40 oranında azalma saptanacağı belirtilmişti.

-British Journal of Cancer çıkan yeni yayın bu çalışmayı destekler niteliktedir.

-Kolon(bağırsak) kanseri tanısı konduktan sonra aspirin kullananlarda tüm nedenlere bağlı ölümlerde %26 azalma saptanmış.

-Fakat aspirinin mide kanaması yapma riski mevcut, başka kan sulandırıcı kullananlar, mide kanaması daha önce geçirenler, sürekli alkol içenlerde, sigara ve H.pilori enfeksiyonu olanlarda bu risk yüksektir.

Sonuç: Aspirin kullanımı, dozu tam bilinmemekle birlikte önerilen 75 mg/gün, özelikle yemek borusu, bağırsak, mide kanserine bağlı ölümleri azaltıcı özeliği vardır. Gözden kaçırılmaması gereken en önemli faktör, 1,2, 3 yıl değil, etkinliğinin görülmesi için en az 5 yıl ve 50 yaş sonrası kullanılmalıdır. Fakat azda olsa ölümcül mide kanamalarına neden olabilir. Doktor kontrolünde risk sınıflanması sonrası karar verilmelidir.



KAYNAK
Post-Diagnosis Aspirin Reduces All-Cause Mortality in CRC
RESEARCH · September 02, 2014

TAKE-HOME MESSAGE
• This meta-analysis evaluated the association between aspirin use after the diagnosis of colorectal cancer and overall survival. Incorporating data from six cohort studies and one case-control study, the authors found that the use of aspirin therapy after cancer diagnosis did not reduce the risk for colorectal cancer–specific mortality. However, all-cause mortality among colorectal cancer patients was reduced with aspirin use.
• The use of aspirin post-diagnosis in colorectal cancer patients reduced all-cause mortality risk but not colorectal cancer–specific mortality risk.
– Jarett Feldman, MD
ABSTRACT
BACKGROUND
Epidemiological evidence suggests that use of aspirin after the diagnosis of colorectal cancer can lengthen survival. However, the supporting data vary between studies, and this hypothesis remains controversial. We conducted a meta-analysis to provide a quantitative assessment of the association between use of aspirin after diagnosis of colorectal cancer and patient survival.
METHODS
We searched the Medline and Embase databases up to April 2014 to identify studies related to aspirin use after diagnosis and all-cause mortality or colorectal cancer-specific mortality. Summary effect estimates with 95% confidence intervals (CIs) were derived using a fixed or random effects model, depending on the heterogeneity between the included studies.
RESULTS
Seven epidemiologic studies that consisted of six cohort studies and one nested case–control study were included in this meta-analysis. The hazard ratio (HR) of the association between aspirin use after colorectal cancer diagnosis and overall mortality, which was reported in five studies, was 0.74 (95% CI, 0.62–0.89) using a random model (heterogeneity test P=0.003, I2=75.3%), and for colorectal cancer-specific mortality (four studies), it was 0.75 (95% CI, 0.51–1.10) using a random model (heterogeneity test P=0.001, I2=84.1%). In addition, we analysed postdiagnosis aspirin use according to whether aspirin was also used before diagnosis. The HR for the overall mortality of patients who did not use aspirin before diagnosis, which was reported in four studies, was 0.84 (95% CI, 0.70–1.00), and for colorectal cancer-specific mortality (three studies), it was 0.79 (95% CI, 0.61–1.02). For those who did use aspirin before diagnosis, the HR for overall mortality (four studies) was 0.88 (95% CI, 0.83–0.93), and for colorectal cancer-specific mortality (three studies), it was 0.80 (95% CI, 0.59–1.09). Subgroup analysis showed that use of aspirin after diagnosis was associated with longer overall survival among patients with the variant PIK3CA gene but not for those with wild-type PIK3CA.
CONCLUSIONS
Based on current evidence, the use of aspirin after diagnosis does not reduce colorectal cancer-specific mortality, but it does reduce all-cause mortality for colorectal cancer patients.
________________________________________
British Journal of Cancer
Relationship Between Aspirin Use After Diagnosis of Colorectal Cancer and Patient Survival: A Meta-Analysis of Observational Studies
Br. J. Cancer 2014 Sep 02;[EPub Ahead of Print], X-F Ye, J Wang, W-T Shi, J He

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