Clinical trials of hereditary colorectal neoplasia
Aspirin has also been investigated in clinical trials among
patients with hereditary conditions with a known genetic
basis, such as familial adenomatous polyposis (FAP) or
Lynch syndrome (hereditary nonpolyposis colorectal carcinoma).
In classic FAP, patients typically develop hundreds
to thousands of adenomatous polyps throughout the
colon, often beginning as early as the second decade of life.
Colorectal adenocarcinomas inevitably develop in FAP
patients, typically by age 40 years, or approximately 10
to 15 years after the initial appearance of polyposis (39). A
germline mutation in the adenomatous polyposis coli
(APC) gene underlies FAP and is a primary molecular event
in up to 85% of sporadic cancers; thus, chemoprevention
studies in these patients have relevance for colorectal
carcinogenesis in the general population.