Updating previous recommendations, the U.S. Preventive Services Task Force now recommends low-dose aspirin for the primary prevention of colorectal cancer among most adults age 50 to 59. This a draft recommendation, but it has generated major media coverage noting that this is the first time the USPSTF has recommended aspirin to prevent colorectal cancer.

In an interview with The ASCO Post, David Johnson, MD, a member of the U.S. Multi-Society Task Force on Colorectal Cancer, expressed concern that some patients may extract part of that information and just start taking aspirin, without considering the potential harms. Dr. Johnson is Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School, Norfolk, and Past President of the American College of Gastroenterology.

Potential harms associated with aspirin use include increased risk of gastrointestinal bleeding and hemorrhagic stroke. The Task Force acknowledged these potential harms, determining that they vary with individual risk but are small in adults aged 59 and younger and small to moderate in adults ages 60 to 69. Dr. Johnson noted that patients may have other risk factors they may or may not be aware of and may be taking other over-the counter nonsteroidal anti-inflammatory drugs (NSAIDs) that could increase the risk of bleeding.

‘May Not Be Quite So Simple’

“Unfortunately, sometimes patients take a part of the information because they want something simple. And it may not be quite so simple,” Dr. Johnson said. “It may be they need to get screened—not just take a pill and prevent a disease.”

To guard against oversimplification, “patients and health-care providers—not just physicians—should communicate well and discuss anything related to a health issue, especially when it comes to something as critical as the prevalent disease of colon cancer in this country, “ Dr. Johnson advised. “I am for anything that will decrease colon cancer,” Dr. Johnson affirmed. He added that a risk-benefit assessment would be a good starting point.

The USPSTF updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer,” is available at www.uspreventiveservicestaskforce.org.  ■