Aspirin Utilization, Compliance and Prevention Of Colorectal Cancer – A Single Centre Perspective.


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Gurpreet Singh Ranger1,Cindy Mckinley-Brown2
1Upper River Valley Hospital, Dalhousie and Memorial Universities,2Upper River Valley Hospital

Abstract

Background

Recent randomised trials indicate daily aspirin may reduce the risk of colorectal cancer by 20%. Aspirin is currently prescribed /self administered to prevent heart disease.

In considering wider population-based chemoprevention against colorectal cancer, a greater understanding of community use, compliance, adverse effects, and patient awareness is required.

We performed a prospective study on aspirin use in our local population.

Method

Prospective data was collected using questionnaires and chart review over six months from every patient attending our general surgical clinic.

Results

Aspirin group: 137 patients; male: 72, female: 65.

76.6% were taking aspirin 81mg. 32.9% did not know what dose, 5.8% took over 300mg tablets.

62% of patients were prescribed aspirin.

25.6% of patients stated they never missed a dose, 39% admitted to missing doses weekly to monthly, 3% never took it despite prescribed.

5.8% reported side effects - minor bruising, bleeding, GI upset, no serious complications reported.

Only 9.5% were aware of the anticancer effects.

Non-aspirin group: 383 patients; male: 135, female: 248.

1% used aspirin in the past but ceased treatment.

4.7% knew of anticancer effects.

Mean age aspirin group vs. non-aspirin 65.8 vs 53.3yrs  (r: 18-100, unpaired t-test, p<0.001).

Patients on aspirin were more likely to be male, without heart disease (IHD) / diabetes and on more than 5 concurrent medications (Fisher’s exact test; p=0.0005, p<0.0001, p <0.002). There was no significant difference between the groups in anticoagulation use, additonal NSAID use or smoking (p = 0.51, p = 0.20, p = 0.19).

Knowledge of anticancer effect showed a trend to significance (p = 0.06) favoring the aspirin intake group.

Conclusion

Aspirin use in our coomunity appears to be in an older age group with less comorbidities. Overall awareness of anticancer effect is low.

These results have implications in strategies for using low dose aspirin in the chemoprevention of colorectal cancer.