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Estimates of benefits and harms of prophylactic use of aspirin in the general population

BACKGROUND: Accumulating evidence supports an effect of aspirin in reducing overall cancer incidence and mortality in the general population. We reviewed current data and assessed the benefits and harms of prophylactic use of aspirin in the general population. METHODS: The effect of aspirin for site...

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Autores principales: Cuzick, J., Thorat, M. A., Bosetti, C., Brown, P. H., Burn, J., Cook, N. R., Ford, L. G., Jacobs, E. J., Jankowski, J. A., La Vecchia, C., Law, M., Meyskens, F., Rothwell, P. M., Senn, H. J., Umar, A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269341/
https://www.ncbi.nlm.nih.gov/pubmed/25096604
http://dx.doi.org/10.1093/annonc/mdu225
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author Cuzick, J.
Thorat, M. A.
Bosetti, C.
Brown, P. H.
Burn, J.
Cook, N. R.
Ford, L. G.
Jacobs, E. J.
Jankowski, J. A.
La Vecchia, C.
Law, M.
Meyskens, F.
Rothwell, P. M.
Senn, H. J.
Umar, A.
author_facet Cuzick, J.
Thorat, M. A.
Bosetti, C.
Brown, P. H.
Burn, J.
Cook, N. R.
Ford, L. G.
Jacobs, E. J.
Jankowski, J. A.
La Vecchia, C.
Law, M.
Meyskens, F.
Rothwell, P. M.
Senn, H. J.
Umar, A.
author_sort Cuzick, J.
collection PubMed
description BACKGROUND: Accumulating evidence supports an effect of aspirin in reducing overall cancer incidence and mortality in the general population. We reviewed current data and assessed the benefits and harms of prophylactic use of aspirin in the general population. METHODS: The effect of aspirin for site-specific cancer incidence and mortality, cardiovascular events was collated from the most recent systematic reviews. Studies identified through systematic Medline search provided data regarding harmful effects of aspirin and baseline rates of harms like gastrointestinal bleeding and peptic ulcer. RESULTS: The effects of aspirin on cancer are not apparent until at least 3 years after the start of use, and some benefits are sustained for several years after cessation in long-term users. No differences between low and standard doses of aspirin are observed, but there were no direct comparisons. Higher doses do not appear to confer additional benefit but increase toxicities. Excess bleeding is the most important harm associated with aspirin use, and its risk and fatality rate increases with age. For average-risk individuals aged 50–65 years taking aspirin for 10 years, there would be a relative reduction of between 7% (women) and 9% (men) in the number of cancer, myocardial infarction or stroke events over a 15-year period and an overall 4% relative reduction in all deaths over a 20-year period. CONCLUSIONS: Prophylactic aspirin use for a minimum of 5 years at doses between 75 and 325 mg/day appears to have favourable benefit–harm profile; longer use is likely to have greater benefits. Further research is needed to determine the optimum dose and duration of use, to identify individuals at increased risk of bleeding, and to test effectiveness of Helicobacter pylori screening–eradication before starting aspirin prophylaxis.
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spelling pubmed-42693412015-03-24 Estimates of benefits and harms of prophylactic use of aspirin in the general population Cuzick, J. Thorat, M. A. Bosetti, C. Brown, P. H. Burn, J. Cook, N. R. Ford, L. G. Jacobs, E. J. Jankowski, J. A. La Vecchia, C. Law, M. Meyskens, F. Rothwell, P. M. Senn, H. J. Umar, A. Ann Oncol Reviews BACKGROUND: Accumulating evidence supports an effect of aspirin in reducing overall cancer incidence and mortality in the general population. We reviewed current data and assessed the benefits and harms of prophylactic use of aspirin in the general population. METHODS: The effect of aspirin for site-specific cancer incidence and mortality, cardiovascular events was collated from the most recent systematic reviews. Studies identified through systematic Medline search provided data regarding harmful effects of aspirin and baseline rates of harms like gastrointestinal bleeding and peptic ulcer. RESULTS: The effects of aspirin on cancer are not apparent until at least 3 years after the start of use, and some benefits are sustained for several years after cessation in long-term users. No differences between low and standard doses of aspirin are observed, but there were no direct comparisons. Higher doses do not appear to confer additional benefit but increase toxicities. Excess bleeding is the most important harm associated with aspirin use, and its risk and fatality rate increases with age. For average-risk individuals aged 50–65 years taking aspirin for 10 years, there would be a relative reduction of between 7% (women) and 9% (men) in the number of cancer, myocardial infarction or stroke events over a 15-year period and an overall 4% relative reduction in all deaths over a 20-year period. CONCLUSIONS: Prophylactic aspirin use for a minimum of 5 years at doses between 75 and 325 mg/day appears to have favourable benefit–harm profile; longer use is likely to have greater benefits. Further research is needed to determine the optimum dose and duration of use, to identify individuals at increased risk of bleeding, and to test effectiveness of Helicobacter pylori screening–eradication before starting aspirin prophylaxis. Oxford University Press 2015-01 2014-08-05 /pmc/articles/PMC4269341/ /pubmed/25096604 http://dx.doi.org/10.1093/annonc/mdu225 Text en © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Reviews
Cuzick, J.
Thorat, M. A.
Bosetti, C.
Brown, P. H.
Burn, J.
Cook, N. R.
Ford, L. G.
Jacobs, E. J.
Jankowski, J. A.
La Vecchia, C.
Law, M.
Meyskens, F.
Rothwell, P. M.
Senn, H. J.
Umar, A.
Estimates of benefits and harms of prophylactic use of aspirin in the general population
title Estimates of benefits and harms of prophylactic use of aspirin in the general population
title_full Estimates of benefits and harms of prophylactic use of aspirin in the general population
title_fullStr Estimates of benefits and harms of prophylactic use of aspirin in the general population
title_full_unstemmed Estimates of benefits and harms of prophylactic use of aspirin in the general population
title_short Estimates of benefits and harms of prophylactic use of aspirin in the general population
title_sort estimates of benefits and harms of prophylactic use of aspirin in the general population
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269341/
https://www.ncbi.nlm.nih.gov/pubmed/25096604
http://dx.doi.org/10.1093/annonc/mdu225
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