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Cited by 984Inflammatory mediators and NSAID effectsAntiplatelet Therapy and Cardiovascular DiseasesCancer, Stress, Anesthesia, and Immune Response

Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials

Rothwell, Peter M, Wilson, Michelle, Price, Jacqueline F, Belch, Jill FF, Meade, Tom W, Mehta, Ziyah·2012·The Lancet
DOI 10.1016/s0140-6736(12)60209-8
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Abstract

Background Daily aspirin reduces the long-term incidence of some adenocarcinomas, but effects on mortality due to some cancers appear after only a few years, suggesting that it might also reduce growth or metastasis. We established the frequency of distant metastasis in patients who developed cancer during trials of daily aspirin versus control. Methods Our analysis included all five large randomised trials of daily aspirin (≥75 mg daily) versus control for the prevention of vascular events in the UK. Electronic and paper records were reviewed for all patients with incident cancer. The effect of aspirin on risk of metastases at presentation or on subsequent follow-up (including post-trial follow-up of in-trial cancers) was stratified by tumour histology (adenocarcinoma vs other) and clinical characteristics. Findings Of 17,285 trial participants, 987 had a new solid cancer diagnosed during mean in-trial follow-up of 6·5 years (SD 2·0). Allocation to aspirin reduced risk of cancer with distant metastasis (all cancers, hazard ratio [HR] 0·64, 95% CI 0·48-0·84, p=0·001; adenocarcinoma, HR 0·54, 95% CI 0·38-0·77, p=0·0007; other solid cancers, HR 0·82, 95% CI 0·53-1·28, p=0·39), due mainly to a reduction in proportion of adenocarcinomas that had metastatic versus local disease (odds ratio 0·52, 95% CI 0·35-0·75, p=0·0006). Aspirin reduced risk of adenocarcinoma with metastasis at initial diagnosis (HR 0·69, 95% CI 0·50-0·95, p=0·02) and risk of metastasis on subsequent follow-up…

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  • 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 [12]

  • 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 [12]

  • 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 [12]

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Authors
Rothwell, P. M., Wilson, M., Price, J. F., Belch, J. F., Meade, T. W., & Mehta, Z.
Affiliations
  • University of Oxford (GB)
  • University of Edinburgh (GB)
  • University of London (GB)
Corresponding author
Rothwell, Peter M
ORCID
Rothwell, Peter M
Venue
The Lancet
Publisher
Elsevier BV
Published
2012-04
Volume
379
Issue
9826
Pages
1591-1601
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(12)60209-8
OpenAlex
W2151840649
Cited by
984
References
1
Citations by year
2026: 23 · 2025: 61 · 2024: 31 · 2023: 45 · 2022: 50 · 2021: 61 · 2020: 71 · 2019: 68 · 2018: 85 · 2017: 86 · 2016: 95 · 2015: 78 · 2014: 78 · 2013: 92 · 2012: 59
FWCI
11.36
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • Discovery Research Portal (University of Dundee) (publishedVersion)
Funders
  • Wellcome Trust (095626)
  • National Institute for Health and Care Research
Topics
  • Health Sciences › Medicine › Pharmacology › Inflammatory mediators and NSAID effects
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
Keywords
aspirin, metastasis, distant metastasis, adenocarcinoma, colorectal cancer, cancer prevention, post-trial follow-up, tumor histology, cancer incidence
MeSH terms
Adenocarcinoma, Antineoplastic Agents, Aspirin, Drug Administration Schedule, Female, Humans, Male, Neoplasm Metastasis, Neoplasms, Platelet Aggregation Inhibitors, Risk Factors, Incidence, Randomized Controlled Trials as Topic

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