Daily Aspirin Use for Longer than 4 Years Associated with Reduced Long-Term Risk of Cancer Death

DynaMed Weekly Update - Volume 5, Issue 50

Aspirin has been linked to a reduction in the risk of certain colorectal cancers (N Engl J Med 2007 May 24;356(21):2131), but its effect on other cancers is unknown. A new systematic review assessed the relationship between aspirin use and overall cancer mortality using data from 8 randomized trials originally designed to evaluate aspirin for primary or secondary prevention of cardiovascular disease. A total of 25,570 patients were randomized to receive daily aspirin (? 75 mg) vs. placebo for ? 4 years. There were 674 total cancer deaths during the trials. Aspirin use was associated with reduced risk of cancer death (odds ratio 0.79, 95% CI 0.68-0.92), with an NNT of 106-429, based on 3% cancer mortality in the control groups (level 2 [mid-level] evidence). In a pooled analysis of individual patient data from 7 trials, there was no significant difference in cancer deaths between aspirin and control groups within the first 5 years of follow-up. However at ? 5 years, aspirin use was associated with reduced risk of death from any cancer (hazard ratio [HR] 0.66, 95% CI 0.5-0.87), from any gastrointestinal cancer (HR 0.46, 95% CI 0.27-0.77), and from any solid cancer (HR 0.64, 95% CI 0ã


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