Dataset Information

Effect of Aspirin on Cancer Incidence and Mortality in Older Adults.

ABSTRACT:

Background

ASPirin in Reducing Events in the Elderly, a randomized, double-blind, placebo-controlled trial of daily low-dose aspirin (100?mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast, prior randomized controlled trials, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality.

Methods

19?114 Australian and US community-dwelling participants aged 70 years and older (US minorities 65 years and older) without cardiovascular disease, dementia, or physical disability were randomly assigned and followed for a median of 4.7?years. Fatal and nonfatal cancer events, a prespecified secondary endpoint, were adjudicated based on clinical records.

Results

981 cancer events occurred in the aspirin and 952 in the placebo groups. There was no statistically significant difference between groups for all incident cancers (hazard ratio [HR] = 1.04, 95% confidence interval [CI] = 0.95 to 1.14), hematological cancer (HR = 0.98, 95% CI = 0.73 to 1.30), or all solid cancers (HR = 1.05, 95% CI = 0.95 to 1.15), including by specific tumor type. However, aspirin was associated with an increased risk of incident cancer that had metastasized (HR = 1.19, 95% CI = 1.00 to 1.43) or was stage 4 at diagnosis (HR = 1.22, 95% CI = 1.02 to 1.45), and with higher risk of death for cancers that presented at stages 3 (HR = 2.11, 95% CI = 1.03 to 4.33) or 4 (HR = 1.31, 95% CI = 1.04 to 1.64).

Conclusions

In older adults, aspirin treatment had an adverse effect on later stages of cancer evolution. These findings suggest that in older persons, aspirin may accelerate the progression of cancer and, thus, suggest caution with its use in this age group.

SUBMITTER: McNeil JJ

PROVIDER: S-EPMC7936068 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Effect of Aspirin on Cancer Incidence and Mortality in Older Adults.

McNeil John J JJ Gibbs Peter P Orchard Suzanne G SG Lockery Jessica E JE Bernstein Wendy B WB Cao Yin Y Ford Leslie L Haydon Andrew A Kirpach Brenda B Macrae Finlay F McLean Catriona C Millar Jeremy J Murray Anne M AM Nelson Mark R MR Polekhina Galina G Reid Christopher M CM Richmond Ellen E Rodríguez Luz Maria LM Shah Raj C RC Tie Jeanne J Umar Asad A Londen G J van GJV Ronaldson Kathlyn K Wolfe Rory R Woods Robyn L RL Zalcberg John J Chan Andrew T AT

Journal of the National Cancer Institute 20210301 3

<h4>Background</h4>ASPirin in Reducing Events in the Elderly, a randomized, double-blind, placebo-controlled trial of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast, prior randomized controlled trials, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality.<h4>Methods</h4>19 114 Australian and US community-dwellin ...[more]

PMID: 32778876

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Dataset Information

Effect of Aspirin on Cancer Incidence and Mortality in Older Adults.

Background

Methods

Results

Conclusions

Publications

Effect of Aspirin on Cancer Incidence and Mortality in Older Adults.

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