Jankowska Helena, Hooper Patricia, Jankowski Janusz A
Richard Hill School, Thurcaston, Leicestershire, United Kingdom.
Pol Arch Med Wewn. 2010 Oct;120(10):407-12.
Together, gastrointestinal (GI) cancers now account for 25% of neoplastic deaths in the West. In Poland, GI cancer rates are likely to increase further as westernization progresses. Given that conventional cancer therapies have made only modest reductions in cancer mortality, there is a great interest in chemoprevention to prevent or slow malignant transformation from premalignant lesions. The financial pressures in the immediate future require even more stringent criteria for chemopreventive agents - they must be cheap but also safe and efficacious. In this regard, several reviews have indicated that aspirin possesses many favorable qualities for chemoprevention. Furthermore, meta-analyses indicate that aspirin may decrease cancer by approximately 30%. Several large clinical trials are underway, including AspECT (Aspirin and Esomeprazole Chemoprevention Trial) that aims not only to prevent cancer but also decrease the gastric side effects by combining aspirin with potent acid-suppressing drugs. In conclusion, whether aspirin will be the world's first proven chemopreventive agent is currently unknown but the evidence looks hopeful.
目前，胃肠道（GI）癌症占西方肿瘤性死亡人数的25%。在波兰，随着西方化进程的推进，胃肠道癌症发病率可能会进一步上升。鉴于传统癌症疗法仅使癌症死亡率略有下降，人们对化学预防以预防或减缓癌前病变的恶性转化兴趣浓厚。近期的财政压力要求化学预防药物的标准更加严格——它们必须价格低廉且安全有效。在这方面，多项综述表明阿司匹林具有许多化学预防的有利特性。此外，荟萃分析表明阿司匹林可能使癌症发病率降低约30%。多项大型临床试验正在进行中，包括阿司匹林和埃索美拉唑化学预防试验（AspECT），该试验不仅旨在预防癌症，还通过将阿司匹林与强效抑酸药物联合使用来减少胃部副作用。总之，阿司匹林是否会成为世界上首个经证实的化学预防药物目前尚不清楚，但证据看起来很有希望。
