The effect of low doses of Aspirin on the occurrence of rectal aberrant crypt foci (ACF)

Abstract

Abstract Purpose: Aberrant crypt foci (ACF) are one of the earliest putative preneoplastic and, in some cases, neoplastic lesions in human colons. Many studies have confirmed the reduction of ACFs and colorectal adenomas after treatment with acetylsalicylic acid (ASA). The objective was to compare the incidence of rectal ACFs and colorectal adenomas in a group of patients taking ASA. Methods: Colonoscopy, combined with rectal mucosa staining with 0.25% methylene blue, was performed on 131 patients. The number of rectal ACF in the colon was divided into three groups: ACF < 5; 5 < ACF < 10; and ACF > 10. Patients were divided into two groups: the "ASA" group - subjects taking ASA 75mg daily for ten years; and "No ASA" group - subjects not taking ASA chronically. The incidence of different types of rectal ACF and colorectal polyps in both groups of subjects was determined. Results: Normal ACF was found in 12.3 in the study group vs 87.7% control group, hyperplastic 22.4 vs 77.6%, dysplastic 25 vs 75%, mixed 0 vs 100%. Treatment with ASA affects the occurrence of colorectal adenomas. The amount of dysplastic ACFs was higher in the control group than in the study group. The increase in dysplastic ACFs decreases with age in both groups, with the increase greater in those not taking ASA. Conclusions: Patients who take persistent, chronic (>10 years) low doses of ASA have a lower total number of all types of rectal ACFs and adenomas compared to the control group.