The role of aspirin in preventing gastrointestinal cancers.

Cancer remains an increasing global health issue and is projected to cause 50% of all global deaths by 2050. Gastrointestinal (GI) tract cancers currently account for approximately 25-30% of all cancer deaths. Consequently, there has been an emerging focus to optimize preventative measures for these cancers through varied avenues such as dietary change, public policy, screening/surveillance via endoscopy and most recently, chemoprevention. There is compelling evidence from both randomized controlled trials and population studies that the use of aspirin results in significant reduction of cancer occurrence in the colon (∼ 10-45% reduction). This could also be applicable to other GI sites, including the esophagus. The implementation of aspirin as a GI cancer prevention measure firstly requires; 1) the optimization of the risk/benefits involving regular uptake of aspirin and 2) the selection of an appropriate population that would benefit from aspirin use, either as a primary prevention or an adjuvant intervention for GI cancer management (and potentially other digestive tract cancers). National guidelines regarding aspirin use for GI chemoprevention are gradually being introduced as more evidence develops.