Department of Clinical Genetics, Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA.
Bioinformatics and Biostatistics, Fox Chase Cancer Center, Philadelphia, PA.
JCO Precis Oncol. 2024 Oct;8:e2400562. doi: 10.1200/PO-24-00562. Epub 2024 Nov 15.
Individuals with Lynch syndrome (LS) are at a high lifetime risk of colorectal cancer (CRC) and other cancers. Aspirin (ASA), a nonsteroidal anti-inflammatory drug (NSAID), has proven chemopreventive benefits in LS, with the CAPP2 randomized double-blind placebo-controlled trial demonstrating a 60% relative risk reduction for CRC among participants who adhered to ASA for 2 years or more. This study sought to characterize uptake of ASA/NSAIDs among individuals with LS and to understand factors associated with use.
Individuals with LS were invited (June 2020-August 2022) to complete a one-time electronic survey about LS screening behaviors, uptake of ASA/NSAIDs, and current/emerging cancer prevention options. Participants were recruited from the Fox Chase Cancer Center (FCCC) Risk Assessment Program Registry and through a research invitation posted to two patient-facing LS advocacy websites.
Two hundred and ninety-six participants completed the survey including 116 (39.2%) from FCCC and 180 (60.8%) recruited via the Internet, including 14.9% non-US based individuals. Uptake of regular ASA or NSAIDs was modest at 34.8% and was even lower (25.7%) when focusing on individuals taking ASA or NSAIDs solely for chemoprevention of LS. More than half (55%) were taking <100 mg ASA daily. In multivariable modeling, lower perceived threat of LS (odds ratio [OR], 0.84 [95% CI, 0.72 to 0.98]), lower (OR, 0.86 [95% CI, 0.76 to 0.99]), and higher were all associated with ASA/NSAIDs use (OR, 1.70 [95% CI, 1.37 to 2.10]).
Uptake of ASA/NSAIDs chemoprevention is modest among individuals with LS. Patient perceptions of the pros and cons of ASA, more so than demographic and disease-related factors, were associated with chemoprevention uptake.
林奇综合征（LS）患者终生结直肠癌（CRC）和其他癌症的风险很高。阿司匹林（ASA）是一种非甾体抗炎药（NSAID），在 LS 中已被证明具有化学预防益处，CAPP2 随机双盲安慰剂对照试验表明，坚持服用 ASA 2 年或以上的参与者 CRC 的相对风险降低了 60%。本研究旨在描述 LS 患者中 ASA/NSAID 的使用情况，并了解与使用相关的因素。
邀请 LS 患者（2020 年 6 月至 2022 年 8 月）完成一项关于 LS 筛查行为、ASA/NSAID 使用情况以及当前/新兴癌症预防选择的一次性电子调查。参与者是从 Fox Chase Cancer Center（FCCC）风险评估计划登记处招募的，以及通过发布在两个面向 LS 患者的倡导网站上的研究邀请招募的。
296 名参与者完成了调查，包括 116 名（39.2%）来自 FCCC 和 180 名（60.8%）通过互联网招募的参与者，其中 14.9%是非美国籍人士。定期服用 ASA 或 NSAID 的比例适中，为 34.8%，而仅为预防 LS 服用 ASA 或 NSAID 的比例更低（25.7%）。超过一半（55%）的人每天服用的 ASA 少于 100 毫克。在多变量模型中，LS 威胁感知较低（比值比 [OR]，0.84 [95%CI，0.72 至 0.98]）、LS 风险较低（OR，0.86 [95%CI，0.76 至 0.99]）和 BMI 较高（OR，1.70 [95%CI，1.37 至 2.10]）均与 ASA/NSAID 的使用相关。
LS 患者的 ASA/NSAID 化学预防使用率适中。患者对 ASA 的利弊的看法，而不是人口统计学和疾病相关因素，与化学预防的使用相关。
