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8. Risk factors for revision of primary total hip arthroplasty: a systematic review

Author

Prokopetz Julian JZ, Losina Elena, Bliss Robin L, Wright John, Baron John A, and Katz Jeffrey N

Subjects
Total hip arthroplasty, Revision, Failure, Risk factor, Aseptic loosening, Infection, Dislocation, Systematic review, Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA), but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN) as compared to osteoarthritis (OA), low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

Published
2012
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9. Development and validation of an index of musculoskeletal functional limitations

Author

Katz Jeffrey N, Wright Elizabeth A, Baron John A, and Losina Elena

Subjects
Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background While musculoskeletal problems are leading sources of disability, there has been little research on measuring the number of functionally limiting musculoskeletal problems for use as predictor of outcome in studies of chronic disease. This paper reports on the development and preliminary validation of a self administered musculoskeletal functional limitations index. Methods We developed a summary musculoskeletal functional limitations index based upon a six-item self administered questionnaire in which subjects indicate whether they are limited a lot, a little or not at all because of problems in six anatomic regions (knees, hips, ankles and feet, back, neck, upper extremities). Responses are summed into an index score. The index was completed by a sample of total knee replacement recipients from four US states. Our analyses examined convergent validity at the item and at the index level as well as discriminant validity and the independence of the index from other correlates of quality of life. Results 782 subjects completed all items of the musculoskeletal functional limitations index and were included in the analyses. The mean age of the sample was 75 years and 64% were female. The index demonstrated anticipated associations with self-reported quality of life, activities of daily living, WOMAC functional status score, use of walking support, frequency of usual exercise, frequency of falls and dependence upon another person for assistance with chores. The index was strongly and independently associated with self-reported overall health. Conclusion The self-reported musculoskeletal functional limitations index appears to be a valid measure of musculoskeletal functional limitations, in the aspects of validity assessed in this study. It is useful for outcome studies following TKR and shows promise as a covariate in studies of chronic disease outcomes.

Published
2009
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10. Deep neural networks for automated classification of colorectal polyps on histopathology slides: A multi-institutional evaluation

Author

Wei, Jason W., Suriawinata, Arief A., Vaickus, Louis J., Ren, Bing, Liu, Xiaoying, Lisovsky, Mikhail, Tomita, Naofumi, Abdollahi, Behnaz, Kim, Adam S., Snover, Dale C., Baron, John A., Barry, Elizabeth L., and Hassanpour, Saeed

Subjects
Electrical Engineering and Systems Science - Image and Video Processing, Computer Science - Computer Vision and Pattern Recognition
Abstract

Histological classification of colorectal polyps plays a critical role in both screening for colorectal cancer and care of affected patients. An accurate and automated algorithm for the classification of colorectal polyps on digitized histopathology slides could benefit clinicians and patients. Evaluate the performance and assess the generalizability of a deep neural network for colorectal polyp classification on histopathology slide images using a multi-institutional dataset. In this study, we developed a deep neural network for classification of four major colorectal polyp types, tubular adenoma, tubulovillous/villous adenoma, hyperplastic polyp, and sessile serrated adenoma, based on digitized histopathology slides from our institution, Dartmouth-Hitchcock Medical Center (DHMC), in New Hampshire. We evaluated the deep neural network on an internal dataset of 157 histopathology slide images from DHMC, as well as on an external dataset of 238 histopathology slide images from 24 different institutions spanning 13 states in the United States. We measured accuracy, sensitivity, and specificity of our model in this evaluation and compared its performance to local pathologists' diagnoses at the point-of-care retrieved from corresponding pathology laboratories. For the internal evaluation, the deep neural network had a mean accuracy of 93.5% (95% CI 89.6%-97.4%), compared with local pathologists' accuracy of 91.4% (95% CI 87.0%-95.8%). On the external test set, the deep neural network achieved an accuracy of 87.0% (95% CI 82.7%-91.3%), comparable with local pathologists' accuracy of 86.6% (95% CI 82.3%-90.9%). If confirmed in clinical settings, our model could assist pathologists by improving the diagnostic efficiency, reproducibility, and accuracy of colorectal cancer screenings.

Published
2019

18. Plasma proteome and incident myocardial infarction: sex-specific differences.

Author

Titova, Olga E, Yuan, Shuai, Byberg, Liisa, Baron, John A, Lind, Lars, Michaëlsson, Karl, and Larsson, Susanna C

Subjects
TUMOR necrosis factor receptors, RETINOIC acid receptors, MYOCARDIAL infarction, PROTEIN receptors, FOLLISTATIN
Abstract

Background and aims Few population-based cohort studies, including both men and women, have explored circulating proteins associated with incident myocardial infarction (MI). This study investigated the relationships between circulating cardiometabolic-related proteins and MI risk using cohort-based and Mendelian randomization (MR) analyses and explored potential sex-specific differences. Methods The discovery cohort included 11 751 Swedish adults (55–93 years). Data on 259 proteins assessed with Olink proximity extension assays, biochemical, and questionnaire-based information were used. Participants were followed up for incident MI and death over 8 years through linkage to Swedish registers. Replication analyses were conducted on the UK Biobank sample (n = 51 613). In MR analyses, index cis -genetic variants strongly related to the proteins were used as instrumental variables. Genetic association summary statistic data for MI were obtained from the CARDIoGRAMplusC4D consortium and FinnGen. Results Forty-five proteins were associated with incident MI in discovery and replication samples following adjustment for potential confounders and multiple testing. In the secondary analysis, 13 of the protein associations were sex-specific, with most associations identified among women. In MR analysis, genetically predicted higher levels of renin, follistatin, and retinoic acid receptor responder protein 2 were linked to an increased risk of MI. Tissue factor pathway inhibitor, tumor necrosis factor receptors 1 and 2, placenta growth factor had an inverse association with MI. Conclusions This study identified both new and confirmed previously established associations between circulating proteins and incident MI and, for the first time, suggested sex-specific patterns in multiple protein-MI associations. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Cumulative Burden of Colorectal Cancer–Associated Genetic Variants Is More Strongly Associated With Early-Onset vs Late-Onset Cancer

Author

Archambault, Alexi N., Su, Yu-Ru, Jeon, Jihyoun, Thomas, Minta, Lin, Yi, Conti, David V., Win, Aung Ko, Sakoda, Lori C., Lansdorp-Vogelaar, Iris, Peterse, Elisabeth F.P., Zauber, Ann G., Duggan, David, Holowatyj, Andreana N., Huyghe, Jeroen R., Brenner, Hermann, Cotterchio, Michelle, Bézieau, Stéphane, Schmit, Stephanie L., Edlund, Christopher K., Southey, Melissa C., MacInnis, Robert J., Campbell, Peter T., Chang-Claude, Jenny, Slattery, Martha L., Chan, Andrew T., Joshi, Amit D., Song, Mingyang, Cao, Yin, Woods, Michael O., White, Emily, Weinstein, Stephanie J., Ulrich, Cornelia M., Hoffmeister, Michael, Bien, Stephanie A., Harrison, Tabitha A., Hampe, Jochen, Li, Christopher I., Schafmayer, Clemens, Offit, Kenneth, Pharoah, Paul D., Moreno, Victor, Lindblom, Annika, Wolk, Alicja, Wu, Anna H., Li, Li, Gunter, Marc J., Gsur, Andrea, Keku, Temitope O., Pearlman, Rachel, Bishop, D. Timothy, Castellví-Bel, Sergi, Moreira, Leticia, Vodicka, Pavel, Kampman, Ellen, Giles, Graham G., Albanes, Demetrius, Baron, John A., Berndt, Sonja I., Brezina, Stefanie, Buch, Stephan, Buchanan, Daniel D., Trichopoulou, Antonia, Severi, Gianluca, Chirlaque, María-Dolores, Sánchez, Maria-José, Palli, Domenico, Kühn, Tilman, Murphy, Neil, Cross, Amanda J., Burnett-Hartman, Andrea N., Chanock, Stephen J., de la Chapelle, Albert, Easton, Douglas F., Elliott, Faye, English, Dallas R., Feskens, Edith J.M., FitzGerald, Liesel M., Goodman, Phyllis J., Hopper, John L., Hudson, Thomas J., Hunter, David J., Jacobs, Eric J., Joshu, Corinne E., Küry, Sébastien, Markowitz, Sanford D., Milne, Roger L., Platz, Elizabeth A., Rennert, Gad, Rennert, Hedy S., Schumacher, Fredrick R., Sandler, Robert S., Seminara, Daniela, Tangen, Catherine M., Thibodeau, Stephen N., Toland, Amanda E., van Duijnhoven, Franzel J.B., Visvanathan, Kala, Vodickova, Ludmila, Potter, John D., Männistö, Satu, Weigl, Korbinian, Figueiredo, Jane, Martín, Vicente, Larsson, Susanna C., Parfrey, Patrick S., Huang, Wen-Yi, Lenz, Heinz-Josef, Castelao, Jose E., Gago-Dominguez, Manuela, Muñoz-Garzón, Victor, Mancao, Christoph, Haiman, Christopher A., Wilkens, Lynne R., Siegel, Erin, Barry, Elizabeth, Younghusband, Ban, Van Guelpen, Bethany, Harlid, Sophia, Zeleniuch-Jacquotte, Anne, Liang, Peter S., Du, Mengmeng, Casey, Graham, Lindor, Noralane M., Le Marchand, Loic, Gallinger, Steven J., Jenkins, Mark A., Newcomb, Polly A., Gruber, Stephen B., Schoen, Robert E., Hampel, Heather, Corley, Douglas A., Hsu, Li, Peters, Ulrike, and Hayes, Richard B.

Published
2020
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24. Risk stratification of individuals with low-risk colorectal adenomas using clinical characteristics: a pooled analysis

Author

Gupta, Samir, Jacobs, Elizabeth T, Baron, John A, Lieberman, David A, Murphy, Gwen, Ladabaum, Uri, Cross, Amanda J, Jover, Rodrigo, Liu, Lin, and Martinez, Maria Elena

Subjects
Colo-Rectal Cancer, Digestive Diseases, Prevention, Clinical Research, Cancer, Adenoma, Age Factors, Aged, Colonic Polyps, Colonoscopy, Colorectal Neoplasms, Female, Humans, Male, Middle Aged, Neoplasms, Multiple Primary, Neoplasms, Second Primary, Population Surveillance, Practice Guidelines as Topic, Risk Assessment, Risk Factors, Tumor Burden, ADENOMA, COLORECTAL CANCER, EPIDEMIOLOGY, POLYP, SURVEILLANCE, Clinical Sciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology
Abstract

ObjectiveFor individuals with 1-2 small (

Published
2017

27. A prognostic model for advanced colorectal neoplasia recurrence

Author

Liu, Lin, Messer, Karen, Baron, John A, Lieberman, David A, Jacobs, Elizabeth T, Cross, Amanda J, Murphy, Gwen, Martinez, Maria Elena, and Gupta, Samir

Subjects
Public Health, Biomedical and Clinical Sciences, Clinical Sciences, Health Sciences, Patient Safety, Prevention, Clinical Research, 4.2 Evaluation of markers and technologies, Adenoma, Adult, Aged, Colorectal Neoplasms, Female, Humans, Male, Middle Aged, Models, Statistical, Neoplasm Recurrence, Local, Prognosis, Prospective Studies, Polyp surveillance, Risk stratification, Epidemiology, Colorectal cancer, Colorectal polyps, Oncology and Carcinogenesis, Public Health and Health Services, Oncology and carcinogenesis
Abstract

PurposeFollowing colonoscopic polypectomy, US Multisociety Task Force (USMSTF) guidelines stratify patients based on risk of subsequent advanced neoplasia (AN) using number, size, and histology of resected polyps, but have only moderate sensitivity and specificity. We hypothesized that a state-of-the-art statistical prediction model might improve identification of patients at high risk of future AN and address these challenges.MethodsData were pooled from seven prospective studies which had follow-up ascertainment of metachronous AN within 3-5 years of baseline polypectomy (combined n = 8,228). Pooled data were randomly split into training (n = 5,483) and validation (n = 2,745) sets. A prognostic model was developed using best practices. Two risk cut-points were identified in the training data which achieved a 10 percentage point improvement in sensitivity and specificity, respectively, over current USMSTF guidelines. Clinical benefit of USMSTF versus model-based risk stratification was then estimated using validation data.ResultsThe final model included polyp location, prior polyp history, patient age, and number, size and histology of resected polyps. The first risk cut-point improved sensitivity but with loss of specificity. The second risk cut-point improved specificity without loss of sensitivity (specificity 46.2 % model vs. 42.1 % guidelines, p

Published
2016

28. Obituary – Anders Ekbom

Author

Ludvigsson,Jonas, Askling,Johan, Cnattingius,Sven, Hall,Per, Klareskog,Lars, Nyren,Olof, Baron,John, Sørensen,Henrik, Ludvigsson,Jonas, Askling,Johan, Cnattingius,Sven, Hall,Per, Klareskog,Lars, Nyren,Olof, Baron,John, and Sørensen,Henrik

Abstract

Jonas F Ludvigsson,1 Johan Askling,1 Sven Cnattingius,1 Per Hall,1 Lars Klareskog,1 Olof Nyren,1 John A Baron,2 Henrik Toft Sørensen3 1Karolinska Institutet, Solna, Sweden; 2University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Aarhus University, Aarhus, DenmarkCorrespondence: Jonas F Ludvigsson, Email jonasludvigsson@yahoo.com

Published
2024

29. Identification of a common variant with potential pleiotropic effect on risk of inflammatory bowel disease and colorectal cancer

Author

Khalili, Hamed, Gong, Jian, Brenner, Hermann, Austin, Thomas R, Hutter, Carolyn M, Baba, Yoshifumi, Baron, John A, Berndt, Sonja I, Bézieau, Stéphane, Caan, Bette, Campbell, Peter T, Chang-Claude, Jenny, Chanock, Stephen J, Chen, Constance, Hsu, Li, Jiao, Shuo, Conti, David V, Duggan, David, Fuchs, Charles S, Gala, Manish, Gallinger, Steven, Haile, Robert W, Harrison, Tabitha A, Hayes, Richard, Hazra, Aditi, Henderson, Brian, Haiman, Chris, Hoffmeister, Michael, Hopper, John L, Jenkins, Mark A, Kolonel, Laurence N, Küry, Sébastien, LaCroix, Andrea, Le Marchand, Loic, Lemire, Mathieu, Lindor, Noralane M, Ma, Jing, Manson, JoAnn E, Morikawa, Teppei, Nan, Hongmei, Ng, Kimmie, Newcomb, Polly A, Nishihara, Reiko, Potter, John D, Qu, Conghui, Schoen, Robert E, Schumacher, Fredrick R, Seminara, Daniela, Taverna, Darin, Thibodeau, Stephen, Wactawski-Wende, Jean, White, Emily, Wu, Kana, Zanke, Brent W, Casey, Graham, Hudson, Thomas J, Kraft, Peter, Peters, Ulrike, Slattery, Martha L, Ogino, Shuji, and Chan, Andrew T

Subjects
Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Genetics, Inflammatory Bowel Disease, Crohn's Disease, Cancer Genomics, Human Genome, Colo-Rectal Cancer, Autoimmune Disease, Cancer, Women's Health, Digestive Diseases, Prevention, 2.1 Biological and endogenous factors, Colitis, Ulcerative, Colorectal Neoplasms, Crohn Disease, Gene Frequency, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Microsatellite Instability, Microsatellite Repeats, Polymorphism, Single Nucleotide, Risk, White People, GECCO and CCFR, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract

Although genome-wide association studies (GWAS) have separately identified many genetic susceptibility loci for ulcerative colitis (UC), Crohn's disease (CD) and colorectal cancer (CRC), there has been no large-scale examination for pleiotropy, or shared genetic susceptibility, for these conditions. We used logistic regression modeling to examine the associations of 181 UC and CD susceptibility variants previously identified by GWAS with risk of CRC using data from the Genetics and Epidemiology of Colorectal Cancer Consortium and the Colon Cancer Family Registry. We also examined associations of significant variants with clinical and molecular characteristics in a subset of the studies. Among 11794 CRC cases and 14190 controls, rs11676348, the susceptibility single nucleotide polymorphism (SNP) for UC, was significantly associated with reduced risk of CRC (P = 7E-05). The multivariate-adjusted odds ratio of CRC with each copy of the T allele was 0.93 (95% CI 0.89-0.96). The association of the SNP with risk of CRC differed according to mucinous histological features (P heterogeneity = 0.008). In addition, the (T) allele was associated with lower risk of tumors with Crohn's-like reaction but not tumors without such immune infiltrate (P heterogeneity = 0.02) and microsatellite instability-high (MSI-high) but not microsatellite stable or MSI-low tumors (P heterogeneity = 0.03). The minor allele (T) in SNP rs11676348, located downstream from CXCR2 that has been implicated in CRC progression, is associated with a lower risk of CRC, particularly tumors with a mucinous component, Crohn's-like reaction and MSI-high. Our findings offer the promise of risk stratification of inflammatory bowel disease patients for complications such as CRC.

Published
2015

37. Diminutive Polyps With Advanced Histologic Features Do Not Increase Risk for Metachronous Advanced Colon Neoplasia

Author

Vleugels, Jasper L.A., Hassan, Cesare, Senore, Carlo, Cassoni, Paola, Baron, John A., Rex, Douglas K., Ponugoti, Prasanna L., Pellise, Maria, Parejo, Sofia, Bessa, Xavier, Arnau-Collell, Coral, Kaminski, Michal F., Bugajski, Marek, Wieszczy, Paulina, Kuipers, Ernst J., Melson, Joshua, Ma, Karen H., Holman, Rebecca, Dekker, Evelien, and Pohl, Heiko

Published
2019
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39. Identification of Genetic Susceptibility Loci for Colorectal Tumors in a Genome-Wide Meta-analysis

Author

Peters, Ulrike, Jiao, Shuo, Schumacher, Fredrick R, Hutter, Carolyn M, Aragaki, Aaron K, Baron, John A, Berndt, Sonja I, Bézieau, Stéphane, Brenner, Hermann, Butterbach, Katja, Caan, Bette J, Campbell, Peter T, Carlson, Christopher S, Casey, Graham, Chan, Andrew T, Chang–Claude, Jenny, Chanock, Stephen J, Chen, Lin S, Coetzee, Gerhard A, Coetzee, Simon G, Conti, David V, Curtis, Keith R, Duggan, David, Edwards, Todd, Fuchs, Charles S, Gallinger, Steven, Giovannucci, Edward L, Gogarten, Stephanie M, Gruber, Stephen B, Haile, Robert W, Harrison, Tabitha A, Hayes, Richard B, Henderson, Brian E, Hoffmeister, Michael, Hopper, John L, Hudson, Thomas J, Hunter, David J, Jackson, Rebecca D, Jee, Sun Ha, Jenkins, Mark A, Jia, Wei–Hua, Kolonel, Laurence N, Kooperberg, Charles, Küry, Sébastien, LaCroix, Andrea Z, Laurie, Cathy C, Laurie, Cecelia A, Le Marchand, Loic, Lemire, Mathieu, Levine, David, Lindor, Noralane M, Liu, Yan, Ma, Jing, Makar, Karen W, Matsuo, Keitaro, Newcomb, Polly A, Potter, John D, Prentice, Ross L, Qu, Conghui, Rohan, Thomas, Rosse, Stephanie A, Schoen, Robert E, Seminara, Daniela, Shrubsole, Martha, Shu, Xiao–Ou, Slattery, Martha L, Taverna, Darin, Thibodeau, Stephen N, Ulrich, Cornelia M, White, Emily, Xiang, Yongbing, Zanke, Brent W, Zeng, Yi–Xin, Zhang, Ben, Zheng, Wei, Hsu, Li, and Registry, Genetics and Epidemiology of Colorectal Cancer Consortium Colon Cancer Family

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Nutrition and Dietetics, Digestive Diseases, Prevention, Genetics, Cancer, Colo-Rectal Cancer, Human Genome, Aetiology, 2.1 Biological and endogenous factors, Age Distribution, Aged, Aged, 80 and over, Colorectal Neoplasms, Cyclin D2, DNA-Binding Proteins, Female, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Incidence, Laminin, Male, Middle Aged, Polymorphism, Single Nucleotide, Prognosis, Risk Assessment, Sex Distribution, T-Box Domain Proteins, Colon Cancer Family Registry and the Genetics and Epidemiology of Colorectal Cancer Consortium, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Abstract

Background & aimsHeritable factors contribute to the development of colorectal cancer. Identifying the genetic loci associated with colorectal tumor formation could elucidate the mechanisms of pathogenesis.MethodsWe conducted a genome-wide association study that included 14 studies, 12,696 cases of colorectal tumors (11,870 cancer, 826 adenoma), and 15,113 controls of European descent. The 10 most statistically significant, previously unreported findings were followed up in 6 studies; these included 3056 colorectal tumor cases (2098 cancer, 958 adenoma) and 6658 controls of European and Asian descent.ResultsBased on the combined analysis, we identified a locus that reached the conventional genome-wide significance level at less than 5.0 × 10(-8): an intergenic region on chromosome 2q32.3, close to nucleic acid binding protein 1 (most significant single nucleotide polymorphism: rs11903757; odds ratio [OR], 1.15 per risk allele; P = 3.7 × 10(-8)). We also found evidence for 3 additional loci with P values less than 5.0 × 10(-7): a locus within the laminin gamma 1 gene on chromosome 1q25.3 (rs10911251; OR, 1.10 per risk allele; P = 9.5 × 10(-8)), a locus within the cyclin D2 gene on chromosome 12p13.32 (rs3217810 per risk allele; OR, 0.84; P = 5.9 × 10(-8)), and a locus in the T-box 3 gene on chromosome 12q24.21 (rs59336; OR, 0.91 per risk allele; P = 3.7 × 10(-7)).ConclusionsIn a large genome-wide association study, we associated polymorphisms close to nucleic acid binding protein 1 (which encodes a DNA-binding protein involved in DNA repair) with colorectal tumor risk. We also provided evidence for an association between colorectal tumor risk and polymorphisms in laminin gamma 1 (this is the second gene in the laminin family to be associated with colorectal cancers), cyclin D2 (which encodes for cyclin D2), and T-box 3 (which encodes a T-box transcription factor and is a target of Wnt signaling to β-catenin). The roles of these genes and their products in cancer pathogenesis warrant further investigation.

Published
2013

41. Aspirin and non-steroidal anti-inflammatory drugs for cancer prevention: an international consensus statement.

Author

Cuzick, Jack, Otto, Florian, Baron, John A, Brown, Powel H, Burn, John, Greenwald, Peter, Jankowski, Janusz, La Vecchia, Carlo, Meyskens, Frank, Senn, Hans Jörg, and Thun, Michael

Subjects
Anti-Inflammatory Agents, Non-Steroidal: adverse effects, therapeutic use, Aspirin: adverse effects, therapeutic use, Breast Neoplasms: prevention & control, Colorectal Neoplasms: prevention & control, Digestive System Neoplasms: prevention & control, Female, Humans, Lung Neoplasms: prevention & control, Neoplasms: prevention & control, Ovarian Neoplasms: prevention & control, Risk, acetylsalicylic acid, cyclooxygenase 2 inhibitor, nonsteroid antiinflammatory agent, placebo, proton pump inhibitor, sulindac, tamoxifen, brain hemorrhage, breast cancer, breast carcinoma, cancer mortality, chemoprophylaxis, clinical trial, colon polyp, colorectal adenoma, colorectal cancer, consensus, drug dose comparison, drug effect, drug efficacy, drug mechanism, drug megadose, drug response, drug safety, duodenum ulcer, esophagus cancer, gastrointestinal hemorrhage, heart infarction, human, low drug dose, lung cancer, lung embolism, malignant neoplastic disease, occlusive cerebrovascular disease, ovary cancer, peptic ulcer, precancer, priority journal, prostate cancer, review, risk benefit analysis, secondary prevention, stomach cancer, stomach ulcer, treatment duration, urinary tract hemorrhage, urogenital tract disease, Anti-Inflammatory Agents, Non-Steroidal, Aspirin, Breast Neoplasms, Colorectal Neoplasms, Digestive System Neoplasms, Female, Humans, Lung Neoplasms, Neoplasms, Ovarian Neoplasms, Risk
Abstract

Evidence clearly shows a chemopreventive effect for aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) on colorectal cancer and probably other cancer types; however, data on the risk-benefit profile for cancer prevention are insufficient and no definitive recommendations can be made. Aspirin has emerged as the most likely NSAID for use in chemoprevention because of its known cardiovascular benefit and available safety and efficacy data. Other traditional NSAIDs, particularly sulindac, and selective COX-2 inhibitors are now given to patients at high risk of colorectal cancer, although these drugs do not provide cardioprotection. More studies of aspirin and cancer prevention are needed to define the lowest effective dose, the age at which to initiate therapy, the optimum treatment duration, and the subpopulations for which the benefits of chemoprevention outweigh the risks of adverse side-effects. Although it might be possible to answer some of these questions with longer follow-up of existing clinical trials, randomised controlled trials with new study designs will be needed. Future projects should investigate the effects of aspirin treatment on multiple organ systems. Cancers of interest are colorectal, breast, prostate, lung, stomach, and oesophageal. The main side-effect of aspirin is peptic ulcers; therefore coadministration of aspirin with a proton-pump inhibitor is an attractive option and is under investigation in the AspECT trial.

Published
2009

47. Circulating bilirubin levels and risk of colorectal cancer: serological and Mendelian randomization analyses

Author

Seyed Khoei, Nazlisadat, Jenab, Mazda, Murphy, Neil, Banbury, Barbara L., Carreras-Torres, Robert, Viallon, Vivian, Kühn, Tilman, Bueno-de-Mesquita, Bas, Aleksandrova, Krasimira, Cross, Amanda J., Weiderpass, Elisabete, Stepien, Magdalena, Bulmer, Andrew, Tjønneland, Anne, Boutron-Ruault, Marie-Christine, Severi, Gianluca, Carbonnel, Franck, Katzke, Verena, Boeing, Heiner, Bergmann, Manuela M., Trichopoulou, Antonia, Karakatsani, Anna, Martimianaki, Georgia, Palli, Domenico, Tagliabue, Giovanna, Panico, Salvatore, Tumino, Rosario, Sacerdote, Carlotta, Skeie, Guri, Merino, Susana, Bonet, Catalina, Rodríguez-Barranco, Miguel, Gil, Leire, Chirlaque, Maria-Dolores, Ardanaz, Eva, Myte, Robin, Hultdin, Johan, Perez-Cornago, Aurora, Aune, Dagfinn, Tsilidis, Konstantinos K., Albanes, Demetrius, Baron, John A., Berndt, Sonja I., Bézieau, Stéphane, Brenner, Hermann, Campbell, Peter T., Casey, Graham, Chan, Andrew T., Chang-Claude, Jenny, Chanock, Stephen J., Cotterchio, Michelle, Gallinger, Steven, Gruber, Stephen B., Haile, Robert W., Hampe, Jochen, Hoffmeister, Michael, Hopper, John L., Hsu, Li, Huyghe, Jeroen R., Jenkins, Mark A., Joshi, Amit D., Kampman, Ellen, Larsson, Susanna C., Le Marchand, Loic, Li, Christopher I., Li, Li, Lindblom, Annika, Lindor, Noralane M., Martín, Vicente, Moreno, Victor, Newcomb, Polly A., Offit, Kenneth, Ogino, Shuji, Parfrey, Patrick S., Pharoah, Paul D. P., Rennert, Gad, Sakoda, Lori C., Schafmayer, Clemens, Schmit, Stephanie L., Schoen, Robert E., Slattery, Martha L., Thibodeau, Stephen N., Ulrich, Cornelia M., van Duijnhoven, Franzel J. B., Weigl, Korbinian, Weinstein, Stephanie J., White, Emily, Wolk, Alicja, Woods, Michael O., Wu, Anna H., Zhang, Xuehong, Ferrari, Pietro, Anton, Gabriele, Peters, Annette, Peters, Ulrike, Gunter, Marc J., Wagner, Karl-Heinz, and Freisling, Heinz

Published
2020
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