Medications to lower colorectal cancer risk

In people at average risk for colorectal cancer, long term use of aspirin can reduce the risk of colorectal polyps and colorectal cancer. 

For people at high risk for colorectal cancer, multiple studies have shown a benefit of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDS).

• In people with Lynch syndrome, daily aspirin may decrease the risk for colon cancer and other cancers. In one study, people who took 600 mg of aspirin daily for two years or more had a 60 percent decrease in their risk for colorectal cancer. However, more studies are needed to help experts understand the best dose and duration of aspirin to protect people with Lynch syndrome from colorectal cancer. 
• Sulindac and celexicob are NSAIDs that have been shown to lower the risk for polyps in people with the rare syndrome Familial Adenomatous Polyposis (FAP). FAP is caused by an  inherited mutation in the APC gene, and is associated with increased risk of young-onset colorectal polyps and colorectal cancer. 

There is still uncertainty about the best dose and which patients may benefit most from routine NSAID use.

Other medications and dietary supplements have been studied through clinical trials, some of which are currently enrolling high-risk people. Currently, there is not enough evidence to support using of any of these other agents for routine chemoprevention of colorectal cancer.

Medications and supplements can have side effects. It is important for people to discuss the benefits and risks of chemoprevention with their doctor. People who choose to take medication to lower risk still need to undergo colorectal cancer screening.