Til Stürmer, MD, MPH; Julie E. Buring, ScD; Robert J. Glynn, PhD, ScD
Potential Financial Conflicts of Interest: Dr. Stürmer receives investigator-initiated research funding and support as principal investigator from the National Institute of Aging, National Institutes of Health. Dr. Buring has received investigator-initiated research funding and support as principal investigator from the National Institutes of Health (National Heart, Lung, and Blood Institute; National Cancer Institute; and National Institute of Aging) and Dow Corning Corporation; research support for pills and/or packaging from Bayer HeathCare and the Natural Source Vitamin E Association; and honoraria from Bayer for speaking engagements. She also serves on an external scientific advisory committee for a study by Procter & Gamble. Dr. Glynn receives investigator-initiated research funding and support as principal investigator from the National Institute of Aging and the National Heart, Lung, and Blood Institute, National Institutes of Health. Drs. Stürmer and Glynn do not accept personal compensation from any pharmaceutical company, although they receive salary support from unrestricted research grants from pharmaceutical companies to the Brigham and Women's Hospital.
Stürmer T., Buring J., Glynn R.; Aspirin and Nonsteroidal Anti-inflammatory Drugs for the Primary Prevention of Colorectal Cancer: Weighing the Evidence. Ann Intern Med. 2007;147:674. doi: 10.7326/0003-4819-147-9-200711060-00022
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Published: Ann Intern Med. 2007;147(9):674.
TO THE EDITOR:
The authors of the review papers on aspirin (1) and nonsteroidal anti-inflammatory drugs (NSAIDs) (2) for the primary prevention of colorectal cancer ignore important limitations of observational studies; raise concerns that are unlikely to be valid (1); and fail to include the analysis on NSAIDs from the Physicians' Health Study (PHS) (3), which was published in the interval covered. The authors correctly discuss shortcomings of randomized trials showing no protection in men and women—that is, low dose and short duration (1). They fail, however, to address shortcomings of observational studies on regular long-term drug use—that is, unmeasured confounding—as an alternative explanation for the reduced risk for colorectal cancer observed in most of these studies.
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