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DH looking at ‘next steps’ for aspirin as cancer prevention evidence grows

The Department of Health is looking at the ‘next steps' for beefing up the role of aspirin in clinical guidelines, after a new analysis showed ‘clinically meaningful' reductions in cancer mortality after just four years of taking the drug.

The move comes after several studies showed aspirin use was associated with a reduction in cancer deaths, and raises the prospect of a surprising about turn for the drug, which is in the process of being written out of many cardiovascular guidelines.

The DH said it was working with the MHRA, NICE and leading cancer charity Cancer Research UK in its response to the mounting positive data for aspirin.

The move comes as NICE reviews its recommendation of low-dose aspirin for primary prevention in diabetes, with some experts suggesting the effect on cancer should be taken in account when treating patients at high cardiovascular risk.

The new meta-analysis – published in June's American Journal of Medicine – found a 23% reduction in cancer mortality in patients taking aspirin. Researchers showed for the first time that significant protective effects could be observed after an average of just four years of follow-up.

They pooled data from 21 randomised studies and 16,000 patients, and found 162 cancer deaths in the group taking aspirin (2%), compared with 210 in controls (2.6%).

Study leader Professor Edward Mills, global health research chair for the Canadian government, said: ‘These findings should be useful for counselling low- and high-risk patients with cardiovascular disease. It seems likely aspirin will now be the backbone of cancer prevention strategies.'

A DH spokesperson said: ‘We are working with the MHRA, NICE and Cancer Research UK to consider the next steps on the benefits of aspirin on preventing cancer.'

NICE confirmed it was also looking at the evidence for aspirin: ‘Use of aspirin for primary prevention of cardiovascular events will be considered in light of new evidence.'

In contrast, the European Society of Cardiology earlier this month removed aspirin as an option for primary prevention of cardio vascular events following a similar move in Scotland in 2010.

Dr Willie Hamilton, senior research fellow in primary healthcare at the University of Bristol and a GP in the city, said: ‘There seems little doubt aspirin reduces cancer incidence, and some suggestion it reduces metastasis. However, the downside of haemorrhage is real. I don't think it's quite ready for GP recommendation yet, though I suspect it will be in time.'

 

Reduction in cancer mortality with aspirin

Months

Cancer mortality risk

36

0.82

42

0.78

52

0.79

72

0.76

80

0.77

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