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Aspirin and other NSAIDS Proved Less Effective in Long-Term Smokers

An increased risk of colorectal cancer has been found among long-term smokers – a large-scale study reports.Researchers at Fred Hutchinson// Cancer Research Center have demonstrated that a lower protective effect of anti-inflammatory drugs such as NSAIDS and aspirin has been noticed among colorectal cancer patients, who are long-term smokers.

In a large, population-based study comparing risk factors in people with and without colorectal cancer, the researchers found the highest risk of colon cancer to be among long-term smokers of 20 or more years who had never used NSAIDs. The researchers also found that smokers who used NSAIDs were still at an approximate 30 percent higher risk of colon cancer than nonsmokers.

The findings, which appear in the July 1 issue of Cancer Research, arise from the first study of its kind to examine the effects of NSAID use on colorectal-cancer risk among smokers, said first author Victoria Chia, a research associate in the Hutchinson Center's Cancer Prevention Program.

‘Smoking has been linked to a modestly increased risk of colorectal cancer, and use of NSAIDs has been shown to significantly decrease the risk of colorectal cancer. We wanted to see if NSAIDs could counteract the adverse effects of smoking with regard to colorectal-cancer risk, and whether these associations differed by tumor characteristics,’ she said.

In particular, Chia and colleagues were interested in examining the impact of NSAIDs on a certain type of colorectal tumor that may be associated with smoking. Such tumors display microsatellite instability, an acquired genetic characteristic that indicates defects in DNA-repair machinery. Microsatellite instability, or MSI, occurs in approximately 15 percent to 20 percent of colon cancers.

The researchers found a two-fold increased risk of microsatellite-unstable colorectal tumors among long-term smokers who took NSAIDs -- about the same risk as smokers who had not used NS
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