A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Cancer Prevention with Resistant Starch in Lynch Syndrome Patients in the CAPP2-Randomized Placebo Controlled Trial : Planned 10-Year Follow-up (2022)


Mathers, J. C., Elliott, F., 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. S., Seppälä, T. T., Thomas, H. J. W., Sheth, H. J., Pylvänäinen, K., Reed, L., . . . Burn, J. (2022). Cancer Prevention with Resistant Starch in Lynch Syndrome Patients in the CAPP2-Randomized Placebo Controlled Trial : Planned 10-Year Follow-up. Cancer Prevention Research, 15(9), 623-634. https://doi.org/10.1158/1940-6207.CAPR-22-0044


JYU-tekijät tai -toimittajat


Julkaisun tiedot

Julkaisun kaikki tekijät tai toimittajat: Mathers, John C.; Elliott, Faye; Macrae, Finlay; Mecklin, Jukka-Pekka; Möslein, Gabriela; McRonald, Fiona E.; Bertario, Lucio; Evans, D. Gareth; Gerdes, Anne-Marie; Ho, Judy W. C.; et al.

Lehti tai sarja: Cancer Prevention Research

ISSN: 1940-6207

eISSN: 1940-6215

Julkaisuvuosi: 2022

Ilmestymispäivä: 25.07.2022

Volyymi: 15

Lehden numero: 9

Artikkelin sivunumerot: 623-634

Kustantaja: American Association for Cancer Research (AACR)

Julkaisumaa: Yhdysvallat (USA)

Julkaisun kieli: englanti

DOI: https://doi.org/10.1158/1940-6207.CAPR-22-0044

Julkaisun avoin saatavuus: Avoimesti saatavilla

Julkaisukanavan avoin saatavuus: Osittain avoin julkaisukanava

Julkaisu on rinnakkaistallennettu (JYX): https://jyx.jyu.fi/handle/123456789/82568


Tiivistelmä

The CAPP2 trial investigated the long-term effects of aspirin and resistant starch on cancer incidence in patients with Lynch syndrome (LS). Participants with LS were randomized double-blind to 30 g resistant starch (RS) daily or placebo for up to 4 years. We present long-term cancer outcomes based on the planned 10-year follow-up from recruitment, supplemented by National Cancer Registry data to 20 years in England, Wales, and Finland. Overall, 463 participants received RS and 455 participants received placebo. After up to 20 years follow-up, there was no difference in colorectal cancer incidence (n = 52 diagnosed with colorectal cancer among those randomized to RS against n = 53 on placebo) but fewer participants had non-colorectal LS cancers in those randomized to RS (n = 27) compared with placebo (n = 48); intention-to-treat (ITT) analysis [HR, 0.54; 95% confidence interval (CI), 0.33–0.86; P = 0.010]. In ITT analysis, allowing for multiple primary cancer diagnoses among participants by calculating incidence rate ratios (IRR) confirmed the protective effect of RS against non–colorectal cancer LS cancers (IRR, 0.52; 95% CI, 0.32–0.84; P = 0.0075). These effects are particularly pronounced for cancers of the upper GI tract; 5 diagnoses in those on RS versus 21 diagnoses on placebo. The reduction in non–colorectal cancer LS cancers was detectable in the first 10 years and continued in the next decade. For colorectal cancer, ITT analysis showed no effect of RS on colorectal cancer risk (HR, 0.92; 95% CI, 0.62–1.34; P = 0.63). There was no interaction between aspirin and RS treatments. In conclusion, 30 g daily RS appears to have a substantial protective effect against non–colorectal cancer cancers for patients with LS.

Prevention Relevance:
Regular bowel screening and aspirin reduce colorectal cancer among patients with LS but extracolonic cancers are difficult to detect and manage. This study suggests that RS reduces morbidity associated with extracolonic cancers.


YSO-asiasanat: syöpätaudit; Lynchin oireyhtymä; paksusuolisyöpä; ilmaantuvuus; ennaltaehkäisy; tärkkelys; asetyylisalisyylihappo; seurantatutkimus


Liittyvät organisaatiot


OKM-raportointi: Kyllä

Raportointivuosi: 2022

JUFO-taso: 1


Viimeisin päivitys 2024-22-04 klo 19:36