Näytä suppeat kuvailutiedot

dc.contributor.authorBurn, John
dc.contributor.authorSheth, Harsh
dc.contributor.authorElliott, Faye
dc.contributor.authorReed, Lynn
dc.contributor.authorMacrae, Finlay
dc.contributor.authorMecklin, Jukka-Pekka
dc.contributor.authorMöslein, Gabriela
dc.contributor.authorMcRonald, Fiona E.
dc.contributor.authorBertario, Lucio
dc.contributor.authorEvans, D. Gareth
dc.contributor.authorGerdes, Anne-Marie
dc.contributor.authorHo, Judy W. C.
dc.contributor.authorLindblom, Annika
dc.contributor.authorMorrison, Patrick J.
dc.contributor.authorRashbass, Jem
dc.contributor.authorRamesar, Raj
dc.contributor.authorSeppälä, Toni
dc.contributor.authorThomas, Huw J. W.
dc.contributor.authorPylvänäinen, Kirsi
dc.contributor.authorBorthwick, Gillian M.
dc.contributor.authorMathers, John C.
dc.contributor.authorBishop, D. Timothy
dc.date.accessioned2020-06-17T10:57:07Z
dc.date.available2020-06-17T10:57:07Z
dc.date.issued2020
dc.identifier.citationBurn, J., Sheth, H., Elliott, F., Reed, L., Macrae, F., Mecklin, J.-P., Möslein, G., McRonald, F. E., Bertario, L., Evans, D. G., Gerdes, A.-M., Ho, J. W. C., Lindblom, A., Morrison, P. J., Rashbass, J., Ramesar, R., Seppälä, T., Thomas, H. J. W., Pylvänäinen, K., . . . Bishop, D. T. (2020). Cancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study : a double-blind, randomised, placebo-controlled trial. <i>The Lancet</i>, <i>395</i>(10240), 1855-1863. <a href="https://doi.org/10.1016/S0140-6736(20)30366-4" target="_blank">https://doi.org/10.1016/S0140-6736(20)30366-4</a>
dc.identifier.otherCONVID_35968961
dc.identifier.urihttps://jyx.jyu.fi/handle/123456789/70030
dc.description.abstractBackground: Lynch syndrome is associated with an increased risk of colorectal cancer and with a broader spectrum of cancers, especially endometrial cancer. In 2011, our group reported long-term cancer outcomes (mean follow-up 55·7 months [SD 31·4]) for participants with Lynch syndrome enrolled into a randomised trial of daily aspirin versus placebo. This report completes the planned 10-year follow-up to allow a longer-term assessment of the effect of taking regular aspirin in this high-risk population. Methods: In the double-blind, randomised CAPP2 trial, 861 patients from 43 international centres worldwide (707 [82%] from Europe, 112 [13%] from Australasia, 38 [4%] from Africa, and four [<1%] from The Americas) with Lynch syndrome were randomly assigned to receive 600 mg aspirin daily or placebo. Cancer outcomes were monitored for at least 10 years from recruitment with English, Finnish, and Welsh participants being monitored for up to 20 years. The primary endpoint was development of colorectal cancer. Analysis was by intention to treat and per protocol. The trial is registered with the ISRCTN registry, number ISRCTN59521990. Findings: Between January, 1999, and March, 2005, 937 eligible patients with Lynch syndrome, mean age 45 years, commenced treatment, of whom 861 agreed to be randomly assigned to the aspirin group or placebo; 427 (50%) participants received aspirin and 434 (50%) placebo. Participants were followed for a mean of 10 years approximating 8500 person-years. 40 (9%) of 427 participants who received aspirin developed colorectal cancer compared with 58 (13%) of 434 who received placebo. Intention-to-treat Cox proportional hazards analysis revealed a significantly reduced hazard ratio (HR) of 0·65 (95% CI 0·43–0·97; p=0·035) for aspirin versus placebo. Negative binomial regression to account for multiple primary events gave an incidence rate ratio of 0·58 (0·39–0·87; p=0·0085). Per-protocol analyses restricted to 509 who achieved 2 years' intervention gave an HR of 0·56 (0·34–0·91; p=0·019) and an incidence rate ratio of 0·50 (0·31–0·82; p=0·0057). Non-colorectal Lynch syndrome cancers were reported in 36 participants who received aspirin and 36 participants who received placebo. Intention-to-treat and per-protocol analyses showed no effect. For all Lynch syndrome cancers combined, the intention-to-treat analysis did not reach significance but per-protocol analysis showed significantly reduced overall risk for the aspirin group (HR=0·63, 0·43–0·92; p=0·018). Adverse events during the intervention phase between aspirin and placebo groups were similar, and no significant difference in compliance between intervention groups was observed for participants with complete intervention phase data; details reported previously. Interpretation: The case for prevention of colorectal cancer with aspirin in Lynch syndrome is supported by our results.en
dc.format.mimetypeapplication/pdf
dc.languageeng
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofseriesThe Lancet
dc.rightsCC BY 4.0
dc.titleCancer prevention with aspirin in hereditary colorectal cancer (Lynch syndrome), 10-year follow-up and registry-based 20-year data in the CAPP2 study : a double-blind, randomised, placebo-controlled trial
dc.typearticle
dc.identifier.urnURN:NBN:fi:jyu-202006174246
dc.contributor.laitosLiikuntatieteellinen tiedekuntafi
dc.contributor.laitosFaculty of Sport and Health Sciencesen
dc.type.urihttp://purl.org/eprint/type/JournalArticle
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1
dc.description.reviewstatuspeerReviewed
dc.format.pagerange1855-1863
dc.relation.issn0140-6736
dc.relation.numberinseries10240
dc.relation.volume395
dc.type.versionpublishedVersion
dc.rights.copyright© 2020 The Author(s). Published by Elsevier Ltd.
dc.rights.accesslevelopenAccessfi
dc.subject.ysosyöpätaudit
dc.subject.ysoLynchin oireyhtymä
dc.subject.ysoennaltaehkäisy
dc.subject.ysosuolistosyövät
dc.subject.ysoasetyylisalisyylihappo
dc.format.contentfulltext
jyx.subject.urihttp://www.yso.fi/onto/yso/p678
jyx.subject.urihttp://www.yso.fi/onto/yso/p23697
jyx.subject.urihttp://www.yso.fi/onto/yso/p19552
jyx.subject.urihttp://www.yso.fi/onto/yso/p25845
jyx.subject.urihttp://www.yso.fi/onto/yso/p6301
dc.rights.urlhttps://creativecommons.org/licenses/by/4.0/
dc.relation.doi10.1016/S0140-6736(20)30366-4
jyx.fundinginformationCancer Research UK, European Union, MRC, NIHR, Bayer Pharma AG, Barbour Foundation.
dc.type.okmA1


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