Aspirin May Accelerate Progression of Advanced Cancers in Older Adults

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Results from a recent clinical trial indicate that for older adults with advanced cancer, initiating aspirin may increase their risk of disease progression and early death. 

Results from a recent clinical trial indicate that for older adults with advanced cancer, initiating aspirin may increase their risk of disease progression and early death. The study, which was conducted by a binational team led by researchers at Massachusetts General Hospital (MGH), the Berman Center in Minnesota, and Monash University in Australia, is published in the Journal of the National Cancer Institute.

Compelling evidence from clinical trials that included predominantly middle-aged adults demonstrates that aspirin may reduce the risk of developing cancer, especially colorectal cancer. Information is lacking for older adults, however.

To provide insights, investigators designed and initiated the ASPirin in Reducing Events in the Elderly (ASPREE) trial, the first randomized double-blind placebo-controlled trial of daily low-dose aspirin (100 mg) in otherwise healthy older adults. The study included 19,114 Australian and U.S. community-dwelling participants aged 70+ years (U.S. minorities 65+ years) without cardiovascular disease, dementia, or physical disability at the start of the study. Participants were randomized to aspirin or placebo and followed for a median of 4.7 years.

In October 2018, the investigators published a very surprising and concerning report showing an association between aspirin use and an elevated risk of death, primarily due to cancer. The current report now provides a more comprehensive analysis of the cancer-related effects of aspirin in the ASPREE participants. "We conducted this study as a more detailed examination of the effect of aspirin on the development of cancer as well as death from cancer," explained senior author Andrew T. Chan, MD, MPH, Chief of the Clinical and Translational Epidemiology Unit at MGH, Director of Epidemiology at the MGH Cancer Center, and a Professor of Medicine at Harvard Medical School.

Read more at Massachusetts General Hospital