Colorectal Adenomas Prevention with Aspirin and EPA?

An UK multicenter, randomized, double-blind, placebo-controlled trial suggests that aspirin and omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) might have chemopreventive effect on colorectal adenomas. Between Nov 11, 2011, and June 10, 2016, 709 patients aged 55–73 years who were identified during colonoscopy as being at high risk were randomly assigned to placebo, EPA (2 g EPA-free fatty acid [FFA] per day, either as the FFA or triglyceride), aspirin (300 mg per day), and EPA plus aspirin. Neither EPA nor aspirin treatment were associated with a reduction in the adenoma detection rate (ADR; the proportion of participants with any adenoma) at 1 year surveillance colonoscopy. However, secondary analyses of the effects of EPA and aspirin on colorectal adenoma number provided evidence of the chemopreventive activity of both agents. Aspirin was effective at reducing the total number of colorectal adenomas per participant. Other secondary analyses suggested that EPA and aspirin have colorectal adenoma subtype-selective and site-selective effects. Participants in EPA group had a reduced total number of and ADR for conventional adenomas in the left colorectum than did those in the placebo group. As well as a reduction in total colorectal adenoma number, participants in aspirin group had a reduced number of adenomas in the right colon, particularly for serrated adenomas, but also a reduced risk of conventional colorectal adenomas. Both agents were well tolerated although the number of gastrointestinal adverse events was increased in the EPA group. The findings are consistent with previous studies. Source: https://www.thelancet.com/