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El cáncer colorrectal (CCR) es un problema de salud pública. Representa el tercer tipo de cáncer más frecuentemente diagnosticado, y la tercera causa de muerte por cáncer en todo el mundo. Así, la prevención y detección temprana siguen siendo estrategias clave para reducir su incidencia y mortalidad. En ese sentido, se ha estudiado a la aspirina, o ácido acetilsalicílico, como agente quimiopreventivo, siendo su uso controversial. Se ha planteado acciones tanto dependientes como independientes de la COX-2, así como efectos directos sobre la célula de CCR e indirectos sobre el microambiente tumoral. La evidencia que relaciona el uso de aspirina con una menor incidencia de CCR es sustancial y ha permitido establecer la recomendación del uso de aspirina a dosis bajas para disminuir la incidencia y mortalidad del CCR en un selecto grupo de pacientes. Además, su uso no debe sustituir el tamizaje ni las otras medidas de prevención. La presente revisión tiene como objetivo sintetizar la literatura disponible en relación a los mecanismos antitumorales de la aspirina y aspectos clínicos relevantes como la edad de inicio, duración, dosis recomendada y seguridad.
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