Population-wide Impact of Long-term Use of Aspirin and the Risk for Cancer

Cao Y, Nishihara R, Wu K, et al. (2017) JAMA Oncology
low-dose-aspirin aspirin cancer colorectal prevention
Title and abstract of Population-wide Impact of Long-term Use of Aspirin and the Risk for Cancer

Key Takeaway

Regular aspirin use for 6+ years was associated with 19% lower risk of colorectal cancer and 15% lower overall cancer risk.

Summary

This large prospective cohort study examined the association between long-term aspirin use and cancer incidence using data from the Nurses' Health Study and Health Professionals Follow-up Study.

Study Population:

  • 135,965 participants
  • Follow-up: Up to 32 years
  • 88,084 women and 47,881 men

Key Findings:

Overall Cancer Risk:

  • Regular aspirin use (≥2 tablets/week) for 6+ years: 3% lower total cancer incidence
  • Most benefit seen after 6 years of continuous use
  • Benefit persisted after stopping aspirin

Colorectal Cancer:

  • 19% reduction in colorectal cancer risk with regular use
  • Strongest effect seen with doses of 0.5-1.5 standard aspirin tablets/day
  • Benefit appeared after ~6 years of use

Gastrointestinal Cancers:

  • 15% reduction in overall GI tract cancers
  • Effects seen for esophageal, stomach, and colorectal cancers

Population Impact:

  • If all US adults 50-64 took aspirin, an estimated 29,800 fewer GI cancers would occur over 10 years
  • This must be balanced against approximately 5,400 excess GI bleeding events

Conclusions:

Long-term aspirin use is associated with meaningful reductions in cancer risk, particularly colorectal cancer. However, benefits take years to emerge and must be weighed against bleeding risks.

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Source

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DOI: 10.1001/jamaoncol.2015.6396