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What’s the Link Between Aspirin and Colorectal Cancer Risk?

Could a common drug in your medicine cabinet help prevent colorectal cancer? Possibly, although nothing in cancer prevention is quite that simple, of course. Studies have shown, however, that aspirin may be beneficial for some people.

[See: 10 Health Pros and Cons of Aspirin.]

What’s the Relationship Between Aspirin and CRC Risk?

Aspirin (acetylsalicylic acid) is a chemical derived from the bark of the willow tree that helps relieve pain and fever. It’s been studied widely for its role in preventing cardiovascular disease, and research indicates there’s a link between aspirin and lowered risk for colorectal cancer, too.

In cohort studies, which follow people for a long time, researchers have observed that individuals taking aspirin for 10 or more years (often for heart disease prevention) have lower rates of colorectal cancer. In fact, in one study, they had a 20 to 30 percent reduced risk of developing CRC, says Dr. Ezra Burstein, chief of the division of digestive and liver diseases at UT Southwestern Medical Center. “We understand that cancers of the colon develop in an environment where there is a lot of inflammation,” Burstein says. “The colon is not a sterile environment, like the brain [for example].” According to the National Cancer Institute, prolonged inflammation can promote changes in cells that line the gastrointestinal tract and lead to the formation of polyps (precancerous growths that can develop into tumors). Aspirin reduces inflammation.

Furthermore, Burstein says, early in the development of a tumor, we see an increase in an enzyme called COX-2, which makes prostaglandins, substances that contribute to characteristics of inflammation, such as swelling and pain. If you block COX-2, as aspirin does, it helps avert the growth of tumors and stop new, abnormal growths from developing into tumors.

Data from clinical trials demonstrate that regular aspirin use significantly decreases the risk of colorectal cancer, says Dr. Dale Shepard, a medical oncologist at the Cleveland Clinic. People who take aspirin have fewer polyps and, after removing existing polyps, they are less likely to develop new ones.

Individuals who have a genetic condition called Lynch syndrome, which significantly increases your risk for CRC, may benefit the most from the protective effects of aspirin. In the CAPP2 clinical trial, high doses of daily aspirin in people with Lynch syndrome were associated with a 63 percent reduction in the relative risk of developing colorectal cancer. Relative risk is the risk of a certain event happening in one group compared to the risk of the same event happening in another group.

Aspirin may also help lower your risk of dying from CRC after diagnosis. “Even people who already have cancer and are undergoing treatment, if they are on aspirin after treatment, they do better than those not taking aspirin,” Burstein says.

This benefit is not for every colorectal cancer patient, however. A study published in June 2017 found that among long-term cancer survivors, regular use of non-steroidal anti-inflammatory drugs (such as aspirin) after diagnosis was associated with a 40 percent improved overall survival only in patients whose tumors had the normal version of a specific gene, KRAS wild-type. This applies to about 70 percent of CRC patients. The other 30 percent of patients who have the mutated version of the KRAS wild-type gene didn’t benefit from regular aspirin use.

[See: 8 Questions to Ask Your Doctor About Colon Cancer.]

Risks of Long-Term Aspirin Use

The U.S. Food and Drug Administration has not approved aspirin for CRC prevention, and adopting the regimen isn’t a good idea for everyone, Shepard says, particularly the elderly, those at risk for strokes and individuals with a history of gastrointestinal bleeding.

The U.S. Preventive Services Task Force recommends low-dose aspirin use for the primary prevention of cardiovascular disease and CRC in adults 50 to 59 who have a 10 percent or greater 10-year risk for cardiovascular disease, are not at increased risk for bleeding, have a life expectancy of at least 10 years and are willing to take low-dose aspirin daily for at least 10 years. Adults in their 60s who have the same life expectancy and risks should talk to their doctor about whether taking aspirin makes sense. There is not enough data to recommend for or against preventive aspirin in adults younger than 50 years or older than 70.

[See: 6 Options for People Who Don’t Want a Colonoscopy.]

Screening Far More Beneficial

Both Shepard and Burstein are quick to point out that for people at average risk, the most important way to prevent CRC is to undergo screening. “Screening is so important in this disease,” Shepard says. “So few cancers have screening for them, but we have it for CRC. Find it early, and it makes a difference.”

The NCI says that among people who are screened for colorectal cancer, regular aspirin use provides added risk reduction and may reduce the risk of interval cancers — those that develop in between regular screenings.

More from U.S. News

8 Questions to Ask Your Doctor About Colon Cancer

6 Options for People Who Don’t Want a Colonoscopy

10 Health Pros and Cons of Aspirin

What’s the Link Between Aspirin and Colorectal Cancer Risk? originally appeared on usnews.com

Don’t Settle for Student Loans to Pay for Online Education

Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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