Safety and efficacy of aspirin for primary prevention of cancer: a meta-analysis of randomized controlled trials.

Aspirin / administration & dosage Humans Neoplasms / mortality Randomized Controlled Trials as Topic
Aspirin Bleeding Cancer Primary prevention

Journal

Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 21 02 2019
accepted: 28 03 2019
pubmed: 18 5 2019
medline: 30 6 2019
entrez: 18 5 2019
Statut: ppublish

Résumé

In the United States, cancer is the second leading cause of mortality, and millions more battle cancer worldwide. As such, primary prevention of cancer is a major interest globally. Aspirin has been studied as a primary prevention method for multiple diseases, mainly cardiovascular disease and various forms of cancer. The role of aspirin as a primary prevention of cancer is still controversial and may be more beneficial in certain cancers over others. With rapidly surfacing large randomized controlled trials (RCTs) studying this subject, we aimed to evaluate the efficacy and safety of aspirin as a primary prophylaxis for cancer. A comprehensive electronic database search was conducted for all RCTs that compared aspirin versus placebo for the prevention of any type of disease, and where cancer incidence or mortality was reported. The primary outcome was cancerrelated mortality. Secondary outcomes were cancer incidence, all-cause mortality, major bleeding, any bleeding and gastrointestinal (GI) bleeding. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) using a random-effects model at the longest follow-up period. We included 16 RCTs with 104,018 total patients, mean age of 60.51 years, mean follow-up of 5.48 years, and a male percentage of 38.72%. We found that aspirin was not associated with a significant reduction of cancer-related mortality compared with placebo (RR 0.99; 95% CI: 0.87-1.12; P = 0.85: I Our study did not find any significant reductions in cancer-related mortality or cancer incidence when compared aspirin use with placebo or no aspirin. Our study also highlights that the use of aspirin for primary prevention of cancer was found to cause higher rates of bleeding (any bleeding, major bleeding, and GI bleeding) compared to placebo or no aspirin at the longest follow-up period with no significant benefit in cancer primary prevention.

Sections du résumé

BACKGROUND BACKGROUND
In the United States, cancer is the second leading cause of mortality, and millions more battle cancer worldwide. As such, primary prevention of cancer is a major interest globally. Aspirin has been studied as a primary prevention method for multiple diseases, mainly cardiovascular disease and various forms of cancer. The role of aspirin as a primary prevention of cancer is still controversial and may be more beneficial in certain cancers over others. With rapidly surfacing large randomized controlled trials (RCTs) studying this subject, we aimed to evaluate the efficacy and safety of aspirin as a primary prophylaxis for cancer.
METHODS METHODS
A comprehensive electronic database search was conducted for all RCTs that compared aspirin versus placebo for the prevention of any type of disease, and where cancer incidence or mortality was reported. The primary outcome was cancerrelated mortality. Secondary outcomes were cancer incidence, all-cause mortality, major bleeding, any bleeding and gastrointestinal (GI) bleeding. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) using a random-effects model at the longest follow-up period.
RESULTS RESULTS
We included 16 RCTs with 104,018 total patients, mean age of 60.51 years, mean follow-up of 5.48 years, and a male percentage of 38.72%. We found that aspirin was not associated with a significant reduction of cancer-related mortality compared with placebo (RR 0.99; 95% CI: 0.87-1.12; P = 0.85: I
CONCLUSION CONCLUSIONS
Our study did not find any significant reductions in cancer-related mortality or cancer incidence when compared aspirin use with placebo or no aspirin. Our study also highlights that the use of aspirin for primary prevention of cancer was found to cause higher rates of bleeding (any bleeding, major bleeding, and GI bleeding) compared to placebo or no aspirin at the longest follow-up period with no significant benefit in cancer primary prevention.

Identifiants

DOI: 10.1007/s00432-019-02932-0 PMID: 31098750
pubmed: 31098750
doi: 10.1007/s00432-019-02932-0
pii: 10.1007/s00432-019-02932-0
doi:

Substances chimiques

Aspirin R16CO5Y76E

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1795-1809

Commentaires et corrections

Type : CommentIn

Références

Lancet. 2001 Jan 13;357(9250):89-95
pubmed: 11197445
Lancet. 1992 Dec 12;340(8833):1421-5
pubmed: 1360557
JAMA. 1992 Sep 9;268(10):1292-300
pubmed: 1507375
Lancet. 1991 Nov 30;338(8779):1345-9
pubmed: 1682734
J Neurol Neurosurg Psychiatry. 1991 Dec;54(12):1044-54
pubmed: 1783914
Yale J Biol Med. 2006 Dec;79(3-4):85-94
pubmed: 17940618
BMJ. 2008 Oct 16;337:a1840
pubmed: 18927173
JAMA. 2008 Nov 12;300(18):2134-41
pubmed: 18997198
Lancet. 2011 Jan 1;377(9759):31-41
pubmed: 21144578
Arch Intern Med. 2012 Feb 13;172(3):209-16
pubmed: 22231610
N Engl J Med. 2012 Nov 22;367(21):1979-87
pubmed: 23121403
Ann Intern Med. 2013 Jul 16;159(2):77-85
pubmed: 23856681
Syst Rev. 2015 Jan 01;4:1
pubmed: 25554246
Sci Transl Med. 2015 Mar 11;7(278):278cm1
pubmed: 25761886
PLoS One. 2015 Jul 07;10(7):e0127194
pubmed: 26151751
Diabetes. 1989 Apr;38(4):491-8
pubmed: 2647556
Ann Intern Med. 2016 Jun 21;164(12):814-25
pubmed: 27064482
JAMA Oncol. 2017 Apr 1;3(4):524-548
pubmed: 27918777
Diabetes Care. 2018 Aug;41(8):1757-1764
pubmed: 29909377
N Engl J Med. 2018 Oct 18;379(16):1529-1539
pubmed: 30146931
N Engl J Med. 2018 Oct 18;379(16):1519-1528
pubmed: 30221595
Int J Cancer. 2019 Jul 1;145(1):267-273
pubmed: 30575949
Dig Dis. 2019;37(5):406-415
pubmed: 30783074
Circulation. 1980 Sep;62(3):449-61
pubmed: 7398002
J Neurol Sci. 1997 Feb 12;145(2):123-5
pubmed: 9094039
Lancet. 1998 Jan 24;351(9098):233-41
pubmed: 9457092

Auteurs

Tarek Haykal (T)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA. haykaltarek@gmail.com.
College of Human Medicine, Michigan State University, East Lansing, MI, USA. haykaltarek@gmail.com.
ORCID: 0000-0002-8637-7292

Mahmoud Barbarawi (M)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Yazan Zayed (Y)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Anitha Yelangi (A)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Harsukh Dhillon (H)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Sowmya Goranta (S)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Babikir Kheiri (B)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Adam Chahine (A)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Varun Samji (V)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

Josiane Kerbage (J)

Department of Anesthesiology, Lebanese University, Beirut, Lebanon.

Khalil Katato (K)

Genessee Hematology & Oncology, PC, Flint, MI, USA.

Ghassan Bachuwa (G)

Department of Internal Medicine, Hurley Medical Center, Flint, MI, USA.
College of Human Medicine, Michigan State University, East Lansing, MI, USA.

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Classifications MeSH

questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures aromatiques › Dérivés du benzène › Phénols › Hydroxybenzoates › Salicylates › Acide acétylsalicylique › Safety and efficacy of aspirin for primary...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Safety and efficacy of aspirin for primary...
questionsmedicales.fr › Tumeurs › Safety and efficacy of aspirin for primary...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études cliniques comme sujet › Essais cliniques comme sujet › Essais cliniques contrôlés comme sujet › Essais contrôlés randomisés comme sujet › Safety and efficacy of aspirin for primary...