Chemoprevention refers to the use of medication, vitamins, or supplements to stop the incidence of cancer, especially in people with a high risk of developing cancer. This study aims to evaluate the comparative safety and efficacy of high-dose aspirin, NSAIDs, calcium, folic acid, and vitamin D for the prevention of advanced metachronous neoplasia in patients with previous colorectal neoplasia.

This systematic review and meta-analysis of 15 randomized controlled trials included a total of 12,234 patients. The trials conducted on adults with pervious colorectal neoplasia whore treated with candidate chemoprevention drugs and placebo were selected. The primary outcome of the study was the risk of metachronous neoplasia, along with serious adverse events.

A meta-analysis of 15 randomized controlled trials using ten different strategies indicated that non-aspirin NSAIDs were the best for preventing advanced metachronous neoplasia (odds ratio 0.37) compared with placebo. However, low-dose aspirin was ranked as the safest chemoprevention agent (0.78). High-dose aspirin had an efficacy (1.12) comparable with low-dose aspirin but had an inferior safety profile. No statistically significant data was available for the use of calcium, folic acid, vitamin D, and other supplements.

The research concluded that non-aspirin NSAIDs were the most efficacious for preventing advanced metachronous neoplasia in patients with previous colorectal neoplasia.

Ref: https://www.bmj.com/content/355/bmj.i6188