Discovery - University of Dundee - Online Publications

Library & Learning Centre

Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death

Standard

Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death : analysis of the time course of risks and benefits in 51 randomised controlled trials. / Rothwell, Peter M.; Price, Jacqueline F.; Fowkes, F. Gerald R.; Zanchetti, Alberto; Roncaglioni, Maria Carla; Tognoni, Gianni; Lee, Robert; Belch, Jill F. F.; Wilson, Michelle; Mehta, Ziyah; Meade, Tom W.

In: Lancet, Vol. 379, No. 9826, 28.04.2012, p. 1602-1612.

Research output: Contribution to journalArticle

Harvard

Rothwell, PM, Price, JF, Fowkes, FGR, Zanchetti, A, Roncaglioni, MC, Tognoni, G, Lee, R, Belch, JFF, Wilson, M, Mehta, Z & Meade, TW 2012, 'Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials' Lancet, vol 379, no. 9826, pp. 1602-1612.

APA

Rothwell, P. M., Price, J. F., Fowkes, F. G. R., Zanchetti, A., Roncaglioni, M. C., Tognoni, G., Lee, R., Belch, J. F. F., Wilson, M., Mehta, Z., & Meade, T. W. (2012). Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet, 379(9826), 1602-1612doi: 10.1016/S0140-6736(11)61720-0

Vancouver

Rothwell PM, Price JF, Fowkes FGR, Zanchetti A, Roncaglioni MC, Tognoni G et al. Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death: analysis of the time course of risks and benefits in 51 randomised controlled trials. Lancet. 2012 Apr 28;379(9826):1602-1612.

Author

Rothwell, Peter M.; Price, Jacqueline F.; Fowkes, F. Gerald R.; Zanchetti, Alberto; Roncaglioni, Maria Carla; Tognoni, Gianni; Lee, Robert; Belch, Jill F. F.; Wilson, Michelle; Mehta, Ziyah; Meade, Tom W. / Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death : analysis of the time course of risks and benefits in 51 randomised controlled trials.

In: Lancet, Vol. 379, No. 9826, 28.04.2012, p. 1602-1612.

Research output: Contribution to journalArticle

Bibtex - Download

@article{de0c6f2dc8364b8bb6ebe3aa72e58d71,
title = "Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death",
author = "Rothwell, {Peter M.} and Price, {Jacqueline F.} and Fowkes, {F. Gerald R.} and Alberto Zanchetti and Roncaglioni, {Maria Carla} and Gianni Tognoni and Robert Lee and Belch, {Jill F. F.} and Michelle Wilson and Ziyah Mehta and Meade, {Tom W.}",
year = "2012",
volume = "379",
number = "9826",
pages = "1602--1612",
journal = "Lancet",
issn = "0140-6736",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Short-term effects of daily aspirin on cancer incidence, mortality, and non-vascular death

T2 - analysis of the time course of risks and benefits in 51 randomised controlled trials

A1 - Rothwell,Peter M.

A1 - Price,Jacqueline F.

A1 - Fowkes,F. Gerald R.

A1 - Zanchetti,Alberto

A1 - Roncaglioni,Maria Carla

A1 - Tognoni,Gianni

A1 - Lee,Robert

A1 - Belch,Jill F. F.

A1 - Wilson,Michelle

A1 - Mehta,Ziyah

A1 - Meade,Tom W.

AU - Rothwell,Peter M.

AU - Price,Jacqueline F.

AU - Fowkes,F. Gerald R.

AU - Zanchetti,Alberto

AU - Roncaglioni,Maria Carla

AU - Tognoni,Gianni

AU - Lee,Robert

AU - Belch,Jill F. F.

AU - Wilson,Michelle

AU - Mehta,Ziyah

AU - Meade,Tom W.

PY - 2012/4/28

Y1 - 2012/4/28

N2 - <p>Background Daily aspirin reduces the long-term risk of death due to cancer. However, the short-term effect is less certain, especially in women, effects on cancer incidence are largely unknown, and the time course of risk and benefit in primary prevention is unclear. We studied cancer deaths in all trials of daily aspirin versus control and the time course of effects of low-dose aspirin on cancer incidence and other outcomes in trials in primary prevention.</p><p>Methods We studied individual patient data from randomised trials of daily aspirin versus no aspirin in prevention of vascular events. Death due to cancer, all non-vascular death, vascular death, and all deaths were assessed in all eligible trials. In trials of low-dose aspirin in primary prevention, we also established the time course of effects on incident cancer, major vascular events, and major extracranial bleeds, with stratification by age, sex, and smoking status.</p><p>Results Allocation to aspirin reduced cancer deaths (562 vs 664 deaths; odds ratio [OR] 0.85, 95% CI 0.76-0.96, p=0.008; 34 trials, 69 224 participants), particularly from 5 years onwards (92 vs 145; OR 0.63, 95% CI 0.49-0.82, p=0.0005), resulting in fewer non-vascular deaths overall (1021 vs 1173; OR 0.88, 95% CI 0.78-0.96, p=0.003; 51 trials, 77 549 participants). In trials in primary prevention, the reduction in non-vascular deaths accounted for 87 (91%) of 96 deaths prevented. In six trials of daily low-dose aspirin in primary prevention (35 535 participants), aspirin reduced cancer incidence from 3 years onwards (324 vs 421 cases; OR 0.76, 95% CI 0.66-0.88, p=0.0003) in women (132 vs 176; OR 0.75, 95% CI 0.59-0.94, p=0.01) and in men (192 vs 245; OR 0.77, 95% CI 0.63-0.93, p=0.008). The reduced risk of major vascular events on aspirin was initially off set by an increased risk of major bleeding, but effects on both outcomes diminished with increasing follow-up, leaving only the reduced risk of cancer (absolute reduction 3.13 [95% CI 1.44-4.82] per 1000 patients per year) from 3 years onwards. Case-fatality from major extracranial bleeds was also lower on aspirin than on control (8/203 vs 15/132; OR 0.32, 95% CI 0.12-0.83, p=0.009).</p><p>Interpretation Alongside the previously reported reduction by aspirin of the long-term risk of cancer death, the short-term reductions in cancer incidence and mortality and the decrease in risk of major extracranial bleeds with extended use, and their low case-fatality, add to the case for daily aspirin in prevention of cancer.</p>

AB - <p>Background Daily aspirin reduces the long-term risk of death due to cancer. However, the short-term effect is less certain, especially in women, effects on cancer incidence are largely unknown, and the time course of risk and benefit in primary prevention is unclear. We studied cancer deaths in all trials of daily aspirin versus control and the time course of effects of low-dose aspirin on cancer incidence and other outcomes in trials in primary prevention.</p><p>Methods We studied individual patient data from randomised trials of daily aspirin versus no aspirin in prevention of vascular events. Death due to cancer, all non-vascular death, vascular death, and all deaths were assessed in all eligible trials. In trials of low-dose aspirin in primary prevention, we also established the time course of effects on incident cancer, major vascular events, and major extracranial bleeds, with stratification by age, sex, and smoking status.</p><p>Results Allocation to aspirin reduced cancer deaths (562 vs 664 deaths; odds ratio [OR] 0.85, 95% CI 0.76-0.96, p=0.008; 34 trials, 69 224 participants), particularly from 5 years onwards (92 vs 145; OR 0.63, 95% CI 0.49-0.82, p=0.0005), resulting in fewer non-vascular deaths overall (1021 vs 1173; OR 0.88, 95% CI 0.78-0.96, p=0.003; 51 trials, 77 549 participants). In trials in primary prevention, the reduction in non-vascular deaths accounted for 87 (91%) of 96 deaths prevented. In six trials of daily low-dose aspirin in primary prevention (35 535 participants), aspirin reduced cancer incidence from 3 years onwards (324 vs 421 cases; OR 0.76, 95% CI 0.66-0.88, p=0.0003) in women (132 vs 176; OR 0.75, 95% CI 0.59-0.94, p=0.01) and in men (192 vs 245; OR 0.77, 95% CI 0.63-0.93, p=0.008). The reduced risk of major vascular events on aspirin was initially off set by an increased risk of major bleeding, but effects on both outcomes diminished with increasing follow-up, leaving only the reduced risk of cancer (absolute reduction 3.13 [95% CI 1.44-4.82] per 1000 patients per year) from 3 years onwards. Case-fatality from major extracranial bleeds was also lower on aspirin than on control (8/203 vs 15/132; OR 0.32, 95% CI 0.12-0.83, p=0.009).</p><p>Interpretation Alongside the previously reported reduction by aspirin of the long-term risk of cancer death, the short-term reductions in cancer incidence and mortality and the decrease in risk of major extracranial bleeds with extended use, and their low case-fatality, add to the case for daily aspirin in prevention of cancer.</p>

U2 - 10.1016/S0140-6736(11)61720-0

DO - 10.1016/S0140-6736(11)61720-0

M1 - Article

JO - Lancet

JF - Lancet

SN - 0140-6736

IS - 9826

VL - 379

SP - 1602

EP - 1612

ER -

Documents

Library & Learning Centre

Contact | Accessibility | Policy