Short-term aspirin and statin chemoprophylaxis did not reduce the risk of developing advanced adenomatous polyps in Black patients

• Published in: BMC gastroenterology Vol. 21; no. 1; p. 379
• Main Authors: Renelus, Benjamin D, Dixit, Devika, Nguyen, Phuong T, Njoku, Kingsley K, Patel, Parth B, Pintor-Jimenez, Katiria, Yan, Fengxia, Buscaglia, Jonathan M, Woods, Kevin E, Jamorabo, Daniel S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.10.2021; BioMed Central; BMC
• Subjects: Adenomatous Polyps; Advanced adenomatous polyps; Age; Aspirin; Aspirin - therapeutic use; Black patients; Blacks; Body mass index; Cell cycle; Chemoprevention; Colon cancer; Colonoscopy; Colorectal cancer; Demographic aspects; Drug therapy; Endoscopy; Gastroenterology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Inflammatory bowel diseases; Intestinal polyps; Medical screening; Patient outcomes; Pharmacy; Polyps; Prevention; Prospective Studies; Retrospective Studies; Risk factors; Statins; Tumors; United States; United States > US; Advanced adenomatous polyps; Black patients; Chemoprevention
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-021-01966-4

Chemoprevention of colorectal neoplasia with aspirin and statins is under-investigated in Black patients. Since Black patients suffer disproportionately from colon cancer incidence and mortality compared to other populations, we investigated the utility of aspirin and statin in reducing advanced adenomatous polyp (AAP) risk in Black patients. We carried out a retrospective cohort study of screening colonoscopies performed at a large urban academic center from 1/1/2011 through 12/31/2019. We analyzed self-identified Black patients with > 1 colonoscopy and no personal history of either inflammatory bowel disease or colon cancer syndromes. Our primary endpoint was first AAP development after index colonoscopy among Black patients taking both aspirin and a statin compared to those taking one or neither medication. We used multivariate logistic regression modeling to investigate our outcomes. We found data on chemoprophylaxis use in 560 patients. The mean observation period between index colonoscopy and AAP identification was 4 years. AAP developed in 106/560 (19%) of our cohort. We found no difference in AAP risk among Black patients taking both chemoprevention medications compared to partial or no chemoprophylaxis (20% vs 18% respectively, p = 0.49). This finding remained after adjusting for age, body mass index, and tobacco use (odds ratio 1.04, 95% CI 0.65-1.67; p = 0.87). Short-term aspirin-statin chemoprevention did not reduce the risk of AAP development in our cohort of Black patients. Larger and long-term prospective investigations are needed to investigate the utility of chemoprophylaxis in this population. Not applicable.