CoChat
Sign Up
Cited by 1,351Inflammatory mediators and NSAID effectsColorectal Cancer Screening and DetectionAntiplatelet Therapy and Cardiovascular Diseases

Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials

Rothwell, Peter M, Wilson, Michelle, Elwin, Carl-Eric, Norrving, Bo, Algra, Ale, Warlow, Charles P, Meade, Tom W·2010·The Lancet
DOI 10.1016/s0140-6736(10)61543-7
Open this paper in CoChat — free account

Abstract

Background High-dose aspirin (≥500 mg daily) reduces long-term incidence of colorectal cancer, but adverse effects might limit its potential for long-term prevention. The long-term effectiveness of lower doses (75-300 mg daily) is unknown. We assessed the effects of aspirin on incidence and mortality due to colorectal cancer in relation to dose, duration of treatment, and site of tumour. Methods We followed up four randomised trials of aspirin versus control in primary (Thrombosis Prevention Trial, British Doctors Aspirin Trial) and secondary (Swedish Aspirin Low Dose Trial, UK-TIA Aspirin Trial) prevention of vascular events and one trial of different doses of aspirin (Dutch TIA Aspirin Trial) and established the effect of aspirin on risk of colorectal cancer over 20 years during and after the trials by analysis of pooled individual patient data. Results In the four trials of aspirin versus control (mean duration of scheduled treatment 6·0 years), 391 (2·8%) of 14 033 patients had colorectal cancer during a median follow-up of 18·3 years. Allocation to aspirin reduced the 20-year risk of colon cancer (incidence hazard ratio [HR] 0·76, 0·60-0·96, p=0·02; mortality HR 0·65, 0·48-0·88, p=0·005), but not rectal cancer (0·90, 0·63-1·30, p=0·58; 0·80, 0·50-1·28, p=0·35). Where subsite data were available, aspirin reduced risk of cancer of the proximal colon (0·45, 0·28-0·74, p=0·001; 0·34, 0·18-0·66, p=0·001), but not the distal colon (1·10, 0·73-1·64, p=0·66; 1·21, 0·66-2·24, p=0…

Integrity signals

Registry

Crossref · 10.1016/s0140-6736(10)61543-7

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In particular, reductions of 30 to 40% in the incidence of gastrointestinal cancers (particularly colorectal cancer) were observed, with the effects appearing to increase with more prolonged exposure and with longer follow-up up to 20 years.

    “In particular, reductions of 30 to 40% in the incidence of gastrointestinal cancers (particularly colorectal cancer) were observed, with the effects appearing to increase with more prolonged exposure and with longer follow-up up to 20 years.”

    From Effects of aspirin for primary prevention in persons with diabetes mellitus (2018) · cites this paper as [11]

  • Retrospective meta-analyses of selected randomized trials of mainly low-dose aspirin have suggested that aspirin use may result in an incidence of cancer or death from cancer that is 15 to 20% lower than that with control.

    “Retrospective meta-analyses of selected randomized trials of mainly low-dose aspirin have suggested that aspirin use may result in an incidence of cancer or death from cancer that is 15 to 20% lower than that with control. 10-13”

    From Effects of aspirin for primary prevention in persons with diabetes mellitus (2018) · cites this paper as [11]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Rothwell, P. M., Wilson, M., Elwin, C.-E., Norrving, B., Algra, A., Warlow, C. P., & Meade, T. W.
Affiliations
  • University of Oxford (GB)
  • Karolinska Institutet (SE)
  • Lund University (SE)
  • University Medical Center Utrecht (NL)
  • Western General Hospital (GB)
  • University of London (GB)
Corresponding author
Rothwell, Peter M
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2010-11
Volume
376
Issue
9754
Pages
1741-1750
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(10)61543-7
OpenAlex
W2102937816
Cited by
1,351
References
1
Citations by year
2026: 38 · 2025: 47 · 2024: 54 · 2023: 63 · 2022: 64 · 2021: 98 · 2020: 96 · 2019: 84 · 2018: 94 · 2017: 90 · 2016: 111 · 2015: 84 · 2014: 95 · 2013: 101 · 2012: 140
FWCI
77.85
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
Funders
National Institute for Health and Care Research
Topics
  • Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
Keywords
aspirin, colorectal cancer, colon cancer, rectal cancer, cancer incidence, cancer mortality, aspirin dose, treatment duration, cancer prevention
MeSH terms
Aspirin, Cardiovascular Diseases, Colonic Neoplasms, Follow-Up Studies, Humans, Thrombosis, Colorectal Neoplasms, Incidence, Randomized Controlled Trials as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review