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A Prospective Study of Aspirin Use and the Risk for Colorectal Adenoma

Andrew T. Chan, MD; Edward L. Giovannucci, MD, ScD; Eva S. Schernhammer, MD, DrPH; Graham A. Colditz, MD, DrPH; David J. Hunter, MD, ScD; Walter C. Willett, MD, DrPH; and Charles S. Fuchs, MD, MPH
[+] Article and Author Information

From Massachusetts General Hospital, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts.


Presented in part at the American Gastroenterological Association's Digestive Disease Week, May 2003, Orlando, Florida.

Acknowledgments: The authors acknowledge the continued dedication of the participants in the Nurses' Health Study and Gideon Aweh, MS, Karen Corsano, MA, and Barbara Egan for assistance.

Grant Support: By grants HL 34594, CA 87969, and CA 55075 from the National Institutes of Health. Dr. Chan is also supported by grant T32DK07191 from the National Institutes of Health.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Andrew T. Chan, MD, Gastrointestinal Unit, Massachusetts General Hospital, 55 Fruit Street, GRJ-722, Boston, MA 02114.

Current Author Addresses: Dr. Chan: Gastrointestinal Unit, Massachusetts General Hospital, 55 Fruit Street, GRJ-722, Boston, MA 02114.

Drs. Giovannucci and Willett: Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Drs. Schernhammer, Colditz, and Hunter: Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115.

Dr. Fuchs: Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02115.

Author Contributions: Conception and design: A.T. Chan, E.L. Giovannucci, E.S. Schernhammer, C.S. Fuchs.

Analysis and interpretation of the data: A.T. Chan, E.L. Giovannucci, E.S. Schernhammer, D.J. Hunter, W.C. Willett, C.S. Fuchs.

Drafting of the article: A.T. Chan, E.S. Schernhammer, G.A. Colditz, W.C. Willett, C.S. Fuchs.

Critical revision of the article for important intellectual content: A.T. Chan, E.L. Giovannucci, G.A. Colditz, D.J. Hunter, W.C. Willett, C.S. Fuchs.

Final approval of the article: A.T. Chan, E.L. Giovannucci, G.A. Colditz, D.J. Hunter, W.C. Willett, C.S. Fuchs.

Provision of study materials or patients: G.A. Colditz, W.C. Willett, C.S. Fuchs.

Statistical expertise: A.T. Chan, E.L. Giovannucci, D.J. Hunter, W.C. Willett, C.S. Fuchs.

Obtaining of funding: E.L. Giovannucci, G.A. Colditz, W.C. Willett, C.S. Fuchs.

Administrative, technical, or logistic support: C.S. Fuchs.

Collection and assembly of data: A.T. Chan, E.L. Giovannucci, G.A. Colditz, W.C. Willett, C.S. Fuchs.


Ann Intern Med. 2004;140(3):157-166. doi:10.7326/0003-4819-140-3-200402030-00006
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Among the 27 077 eligible women, we documented 1368 pathologically confirmed cases of adenoma of the distal colon and rectum. Within this cohort, 38% were regular aspirin users, defined as taking 2 or more standard aspirin tablets per week. Compared with participants who did not report aspirin use, women reporting the highest levels of use were less likely to exercise regularly and were more likely to have a family history of colorectal cancer; to take multivitamins; and to undergo endoscopy for bleeding, abdominal pain, or change in bowel habits. In addition, women who reported more frequent aspirin use consumed more alcohol and folate (Table 1).

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Summary for Patients

Relationships between Aspirin Dose and Colorectal Adenomas

The summary below is from the full report titled “A Prospective Study of Aspirin Use and the Risk for Colorectal Adenoma.” It is in the 3 February 2004 issue of Annals of Internal Medicine (volume 140, pages 157–166). The authors are A.T. Chan, E.L. Giovannucci, E.S. Schernhammer, G.A. Colditz, D.J. Hunter, W.C. Willett, and C.S. Fuchs.

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