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Cited by 1,497Inflammatory mediators and NSAID effectsAntiplatelet Therapy and Cardiovascular DiseasesMetabolism, Diabetes, and Cancer

Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials

Rothwell, Peter M, Fowkes, F Gerald R, Belch, Jill FF, Ogawa, Hisao, Warlow, Charles P, Meade, Tom W·2011·The Lancet
DOI 10.1016/s0140-6736(10)62110-1
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Abstract

Background Treatment with daily aspirin for 5 years or longer reduces subsequent risk of colorectal cancer. Several lines of evidence suggest that aspirin might also reduce risk of other cancers, particularly of the gastrointestinal tract, but proof in man is lacking. We studied deaths due to cancer during and after randomised trials of daily aspirin versus control done originally for prevention of vascular events. Methods We used individual patient data from all randomised trials of daily aspirin versus no aspirin with mean duration of scheduled trial treatment of 4 years or longer to determine the effect of allocation to aspirin on risk of cancer death in relation to scheduled duration of trial treatment for gastrointestinal and non-gastrointestinal cancers. In three large UK trials, long-term post-trial follow-up of individual patients was obtained from death certificates and cancer registries. Results In eight eligible trials (25 570 patients, 674 cancer deaths), allocation to aspirin reduced death due to cancer (pooled odds ratio [OR] 0·79, 95% CI 0·68-0·92, p=0·003). On analysis of individual patient data, which were available from seven trials (23 535 patients, 657 cancer deaths), benefit was apparent only after 5 years' follow-up (all cancers, hazard ratio [HR] 0·66, 0·50-0·87; gastrointestinal cancers, 0·46, 0·27-0·77; both p=0·003). The 20-year risk of cancer death (1634 deaths in 12 659 patients in three trials) remained lower in the aspirin groups than in the cont…

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Crossref · 10.1016/s0140-6736(10)62110-1

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  • Several meta-analyses of selected randomized trials of generally low-dose aspirin have suggested that aspirin use might reduce the risk of cancer-in particular gastrointestinal tract cancer-by up to one third during long-term follow-up, with effects becoming apparent approximately 3 years after randomization.

    “Several meta-analyses of selected randomized trials of generally low-dose aspirin have suggested that aspirin use might reduce the risk of cancer - in particular, gastrointestinal tract cancer - by up to one third during long-term follow-up, with effects becoming apparent approximately 3 years after randomization.”

    From Effects of aspirin for primary prevention in persons with diabetes mellitus (2018) · cites this paper as [24]

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Authors
Rothwell, P. M., Fowkes, F. G. R., Belch, J. F., Ogawa, H., Warlow, C. P., & Meade, T. W.
Affiliations
  • University of Oxford (GB)
  • University of Edinburgh (GB)
  • Kumamoto University (JP)
  • Western General Hospital (GB)
  • University of London (GB)
Corresponding author
Rothwell, Peter M
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2011-01
Volume
377
Issue
9759
Pages
31-41
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(10)62110-1
OpenAlex
W2151036184
Cited by
1,497
References
4
Citations by year
2026: 35 · 2025: 38 · 2024: 44 · 2023: 57 · 2022: 56 · 2021: 83 · 2020: 79 · 2019: 101 · 2018: 99 · 2017: 110 · 2016: 119 · 2015: 125 · 2014: 127 · 2013: 143 · 2012: 163
FWCI
15.30
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (submittedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
Funders
National Institute for Health and Care Research (RP-PG-0606-1146)
Topics
  • Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Metabolism, Diabetes, and Cancer
Keywords
aspirin, cancer mortality, cancer prevention, gastrointestinal cancer, long-term follow-up, individual patient data, post-trial follow-up, esophageal cancer, colorectal cancer, pooled odds ratio, hazard ratio
MeSH terms
Aspirin, Drug Administration Schedule, Humans, Neoplasms, Survival Analysis, Randomized Controlled Trials as Topic, Cyclooxygenase 2 Inhibitors

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