The United States Preventive Services Task Force (USPSTF) çalışama gurubu; Türkçesi Birleşik Devletler Önleyici Hizmetler Çalışma Grubu önerileri
-50 ile 69 yaşları arasında 10 yıldan fazla yaşam beklentisi olan ve en az 10 yıl süresince düşük doz aspirin alabileceklere önermektedir.
-Bu öneri ile kalp hastalıkları ve kolon(bağırsak) kanseri gelişiminin önemli oranda azaltılması öngörülmektedir.
-Özelikle kalp hastalığı riski 10 yıl içinde %10 fazla olduğu öngörülüyorsa
-Önleyici amaçlı aspirin dozu 75 mg/ gün şeklinde ve mide kanaması riski olmayanlara önerilmektedir.
-50 yaşından genç ve 70 yaşından yaşlılarda, kalp hastalığı ve bağırsak kanserini azatlığına dair yeterince kanıt olmadığı için mevcut durumda önerilmemektedir.
-Önemli ve unutulmaması gereken diğer bir husus, önleyici amaçlı alınan düşük doz aspirine kontrendikasyon yok ise en az 10 yıl devam etmesi gerektiğidir.
-Koruyucu amaçlı aspirinin kalp hastalığı ve bağırsak kanseri önlemesinde etkili olması için 10 yıl süresince düzenli alınması gerekmektedir.
Sonuç olarak: 50—69 yaş aralığında olan kalp hastalığı riski olanlar doktoruna danışarak önleyici amaçlı düşük doz aspirin kullanması, bağırsak kanseri önlemede ve kalp hastalığını önlemede etkilidir.
News | September 16, 2015 | Colorectal Cancer, Gastrointestinal Cancer
By Leah Lawrence
USPSTF Supports Aspirin for Colorectal Cancer Prevention
The United States Preventive Services Task Force (USPSTF) recently issued a draft recommendation advising the use of aspirin to prevent cardiovascular disease and colorectal cancer in certain patients aged 50 to 69 years.
The USPSTF found that taking aspirin can help 50- to 69-year-olds who are at increased risk of cardiovascular disease prevent heart attacks and stroke, as well as help prevent colorectal cancer, if taken for at least 10 years.
According to a press release, the USPSTF approached this recommendation in a new way.
“Each person has only one decision to make—whether or not to take aspirin for prevention,” says task force member Douglas K. Owens, MD, MS. “To help individuals and their clinicians make this decision, the task force integrated the evidence about the use of aspirin to prevent cardiovascular disease and colorectal cancer into one recommendation on the use of aspirin.”
The draft recommended that adults aged 50 to 59 years use low-dose aspirin for primary prevention of cardiovascular disease and colorectal cancer who have a 10% or greater 10-year risk for cardiovascular disease, are not at an increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for 10 years. This was a B grade recommendation.
In adults aged 60 to 69 years, the USPSTF said individuals with more than a 10% 10-year cardiovascular disease risk must make individual decisions about whether or not to use aspirin for prevention. This C grade level recommendation stated that a greater benefit would be seen among people who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years.
In adults younger than 50 and older than 70, the USPSTF said there is not enough evidence to assess whether the benefits of aspirin to prevent cardiovascular disease and colorectal cancer outweigh the harms.
To develop to these recommendations, the USPSTF commissioned three systemic evidence reviews and a decision analysis model. The primary studies included for all three reviews focused on primary prevention of cardiovascular disease. Specifically, the review included 11 randomized clinical trials looking at aspirin to prevent cardiovascular events published since the last USPSTF review in 2009. The review also included three trials evaluating primary and secondary cardiovascular disease that reported a 40% reduction in colorectal cancer incidence with the use of aspirin; however, this benefit was only seen after at least 5 to 10 years of aspirin use.
Commenting on the draft recommendation, Andrew T. Chan, MD, MPH, program director for the gastroenterology training program at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School, called it a step in the right direction.
“First, it acknowledges the substantial body of evidence that has accumulated to date that aspirin reduces the risk of colorectal cancer,” Chan said. “Second, it recognizes that the decision to take aspirin is complex, requiring an appreciation of not only its benefits against colorectal cancer but also its role in cardiovascular disease prevention and its potential hazards. Taking into account all of these factors is challenging but necessary for any recommendation to make sense in clinical practice.”