Journal article
Colorectal polyp outcomes after participation in the seAFOod polyp prevention trial: evidence of rebound elevated colorectal polyp risk after short-term aspirin use
- Abstract:
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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.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 588.4KB, Terms of use)
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- Publisher copy:
- 10.1111/apt.17646
Authors
- Publisher:
- Wiley
- Journal:
- Alimentary Pharmacology and Therapeutics More from this journal
- Volume:
- 58
- Issue:
- 6
- Pages:
- 562-572
- Publication date:
- 2023-07-30
- Acceptance date:
- 2023-07-07
- DOI:
- EISSN:
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1365-2036
- ISSN:
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0269-2813
- Pmid:
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37518954
- Language:
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English
- Keywords:
- Pubs id:
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1510257
- Local pid:
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pubs:1510257
- Deposit date:
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2023-12-29
Terms of use
- Copyright holder:
- Downing et al.
- Copyright date:
- 2023
- Rights statement:
- © 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.
- Licence:
- CC Attribution (CC BY)
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