We shouldn’t make a fundamental change in practice on the basis of this kind of evidence. If we are really going to recommend aspirin in this way it should be done as part of national guidance. I will say to my patients that the research is interesting, and has exciting potential, but needs further analysis in the context of other research before clear guidance can be issued. Possibly, a body such as NICE will do this.
Patients should also be advised that there are trials under way that will provide greater certainty about the benefits and harms of aspirin therapy in cancer prevention, but the results will not be available for a few years.
For the moment it might be better to wait a few months for the fuss to die down and see what the consensus of opinion is before rushing into taking aspirin (which is not licensed for cancer prevention in any case).
A good review of this paper is provided by NHS Choices that you can refer patients to.
Remember, some years ago aspirin was recommended for primary prevention (in those without the disease) of cardiovascular disease, and we now don’t think this was a good idea. Evidence changes.
Dr Martin Duerden is a part-time GP and clinical adviser to the RCGP on prescribing