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Chemoprevention in Lynch syndrome.

Abstract
CAPP1 tested aspirin 600 mg/day and/or resistant starch 30 g/day in 200 adolescent FAP carriers. Aspirin treatment resulted in a non-significant reduction in polyp number and a significant reduction in polyp size among patients treated with aspirin for more than 1 year. CAPP2 RCT used the same interventions in 937 Lynch syndrome patients, the first RCT to have cancer prevention as the primary endpoint. Aspirin did not reduce the risk of colorectal neoplasia in a mean treatment period of 29 months but double blind post intervention follow-up has revealed 48 participants developed 53 CRCs. Per protocol analysis showed 63% fewer colon cancers with aspirin (p = 0.008) apparent from 4 years, with a similar effect on other LS cancers. Resistant starch was not beneficial at long term followup. CAPP3 will involve a double blind dose non-inferiority trial comparing 100, 300 or 600 mg daily in 3,000 gene carriers. We can now recommend aspirin in people at high risk of colorectal cancer.
AuthorsJohn Burn, John C Mathers, D Tim Bishop
JournalFamilial cancer (Fam Cancer) Vol. 12 Issue 4 Pg. 707-18 (Dec 2013) ISSN: 1573-7292 [Electronic] Netherlands
PMID23880960 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Starch
  • Aspirin
Topics
  • Adolescent
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Aspirin (therapeutic use)
  • Colorectal Neoplasms, Hereditary Nonpolyposis (drug therapy, prevention & control)
  • Female
  • Follow-Up Studies
  • Humans
  • International Agencies
  • Male
  • Prognosis
  • Starch (therapeutic use)

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