Review: Daily aspirin reduces long-term risk for death due to some types of cancer

Singh, Sonal
March 2011
ACP Journal Club;3/20/2011, Vol. 154 Issue 3, p1
Academic Journal
Question Does daily use of aspirin reduce risk for cancer mortality? Review scope Included studies compared aspirin (any dose) with no aspirin and had a mean or median scheduled treatment duration >4 years. Trials could include other antiplatelet or antithrombotic agents if they were used in the same way in the aspirin and no-aspirin groups. Outcome was death due to cancer. Review methods Antithrombotic Trialists Collaboration (last search 2002); MEDLINE and EMBASE/Excerpta Medica (2002 to Mar 2010); and Cochrane Database of Systematic Reviews were searched for randomized trials. Investigators were contacted for original data. 8 trials (n =>25>570) met the selection criteria; individual patient data were available for 7 (n =>23>535), and 3 (n =>12>659) included long-term posttrial follow-up data from cancer registries and national death certificates. Trials were done for prevention of vascular disease. Daily dose of aspirin ranged from 75 mg to 1200 mg. Intention-to-treat analysis was used for individual patient data. Main results Individual patient data meta-analysis showed that aspirin reduced overall risk for death due to cancer more than no aspirin (Table). In analyses by follow-up time, aspirin reduced risk for death from any cancer and from gastrointestinal (GI) cancer more than no aspirin at é>5 years and from any cancer, GI, and non-GI solid cancer at 20 years; groups did not differ at >5 years of follow-up (Table). Aspirin and no-aspirin groups did not differ for death due to hematologic cancer at any time point. Conclusion Daily use of aspirin reduces long-term risk for death due to some types of cancer.


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