Aspirin does not provide protection against Lynch syndrome

Aspirin, recommended as a preventive approach for patients at risk of hereditary colorectal cancer, does not provide protection against Lynch syndrome, the most common form of hereditary colorectal cancer, according a study published in the Dec. 11 issue of the New England Journal of Medicine.

Henry Lynch, M.D., professor of medicine and director Creighton University Hereditary Cancer Center, is a co-author and chair of the multinational steering committee conducting the study. Lynch first identified Lynch Syndrome, also known as hereditary nonpolyposis colorectal cancer, in the 1960s.

“Aspirin has been used clinically for some time in patients at risk of Lynch syndrome, but our study shows that patients who take aspirin for this reason are simply wasting their time,” Lynch said. “The best protection continues to be an annual colonoscopy, beginning at age 25.”

For the study, led by John Burn, M.D., professor at Newcastle University, United Kingdom, 846 men and women at risk of Lynch Syndrome participated at 43 medical centers. Treatments for the study, which also looked at resistant starch as a preventive agent, were given to participants for up to four years, Lynch said. One-third of the patients received aspirin; one-third, resistant starch; and one-third, placebo.

During the trial, benign, premalignant or malignant growths were found in similar proportions among participants receiving aspirin versus placebos. Patients receiving aspirin (600 mg per day) or a placebo developed abnormal growths 18.9 percent of the time, compared to 19 percent for those taking placebos, respectively. Patients receiving resistant starch (30 g per day) or a placebo also had similar results (18.7 percent versus 18.4 percent), the study showed.

Lynch said the research team will use data and design strategies from the study to conduct further investigations to find possible cancer-preventive treatments for patients predisposed to Lynch syndrome. Lynch will also oversee that study as well.

Lynch syndrome accounts for approximately one in every 35 colorectal cancers in the United States.