NCRAS data has been used to follow up long term outcomes for people participating in an important cancer prevention trial. The CAPP2 clinical trial of aspirin and resistant starch looked at cancer incidence in around 1000 patients with Lynch syndrome (LS) – these people have a high genetic risk of bowel, womb and other cancers, including upper gut tumours.
The NDRS Molecular & Genomics Team has been working closely with Professor Sir John Burn and his team at Newcastle University. We linked the CAPP2 trial records to gold standard English and Welsh cancer registration data, to see what tumours had developed over the 10-20 years since each patient started on the trial.
In a previous publication in
The Lancet, the CAPP2 / NCRAS work showed that taking a daily aspirin for two years could halve the incidence of colorectal cancer over the next decade in people with LS. Our new paper in
Cancer Prevention Research showed that consumption of resistant starch (equivalent to a daily banana) prevented 60% of upper gut cancers. Everyone in the trial was included in the analysis, even if they dropped out early: this is known as ‘intention to treat’ and is the highest bar for a clinical trial.
Resistant starch is defined as carbohydrates that can be fermented by gut bacteria. It probably alters the mix of microbes living in the gut, encouraging the ‘good bacteria’ to predominate. Both aspirin and resistant starch are cheap, readily available, and safe. It’s a great example of using NDRS data to support cutting edge clinical research to help those people most vulnerable to cancer.