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dc.contributor.authorMcNeil, John J
dc.contributor.authorGibbs, Peter
dc.contributor.authorOrchard, Suzanne G
dc.contributor.authorLockery, Jessica E
dc.contributor.authorBernstein, Wendy B
dc.contributor.authorCao, Yin
dc.contributor.authorFord, Leslie
dc.contributor.authorHaydon, Andrew
dc.contributor.authorKirpach, Brenda
dc.contributor.authorMacrae, Finlay
dc.contributor.authorMcLean, Catriona
dc.contributor.authorMillar, Jeremy
dc.contributor.authorMurray, Anne M
dc.contributor.authorNelson, Mark R
dc.contributor.authorPolekhina, Galina
dc.contributor.authorReid, Christopher
dc.contributor.authorRichmond, Ellen
dc.contributor.authorRodríguez, Luz Maria
dc.contributor.authorShah, Raj C
dc.contributor.authorTie, Jeanne
dc.contributor.authorUmar, Asad
dc.contributor.authorvan Londen, G.J.
dc.contributor.authorRonaldson, Kathlyn
dc.contributor.authorWolfe, Rory
dc.contributor.authorWoods, Robyn L
dc.contributor.authorZalcberg, John
dc.contributor.authorChan, Andrew T
dc.contributor.authorASPREE Investigator Group
dc.date.accessioned2020-08-28T00:20:25Z
dc.date.available2020-08-28T00:20:25Z
dc.date.issued2020
dc.identifier.citationMcNeil, J.J. and Gibbs, P. and Orchard, S.G. and Lockery, J.E. and Bernstein, W.B. and Cao, Y. and Ford, L. et al. 2020. Effect of aspirin on cancer incidence and mortality in older adults. Journal of the National Cancer Institute.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/80802
dc.identifier.doi10.1093/jnci/djaa114
dc.description.abstract

BACKGROUND: ASPirin in Reducing Events in the Elderly (ASPREE), a randomized double-blind placebo-controlled trial (RCT) of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast prior RCTs, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality. METHODS: 19,114 Australian and U.S. community-dwelling participants aged 70+ years (U.S. minorities 65+ years) without cardiovascular disease, dementia or physical disability were randomized and followed for a median of 4.7 years. Fatal and non-fatal cancer events, a prespecified secondary endpoint, were adjudicated based on clinical records. RESULTS: 981 cancer events occurred in the aspirin and 952 in the placebo groups. There was no statistically significant difference between groups for all incident cancers (HR = 1.04, 95% CI = 0.95 to 1.14), hematological cancer (HR = 0.98, 95% CI = 0.73 to 1.30), or all solid cancers (HR = 1.05, 95% CI = 0.95 to 1.15), including by specific tumor type. However, aspirin was associated with an increased risk of incident cancer that had metastasized (HR = 1.19, 95% CI = 1.00 to 1.43) or was stage 4 at diagnosis (HR = 1.22, 95% CI = 1.02 to 1.45), and with higher risk of death for cancers that presented at stages 3 (HR = 2.11, 95% CI = 1.03 to 4.33) or 4 (HR = 1.31, 95% CI = 1.04 to 1.64). CONCLUSIONS: In older adults, aspirin treatment had an adverse effect on later stages of cancer evolution. These findings suggest that in older persons, aspirin may accelerate the progression of cancer and thus, suggest caution with its use in this age group.

dc.languageeng
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/334047
dc.relation.sponsoredbyhttp://purl.org/au-research/grants/nhmrc/1127060
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectASPREE Investigator Group
dc.titleEffect of aspirin on cancer incidence and mortality in older adults.
dc.typeJournal Article
dcterms.source.issn0027-8874
dcterms.source.titleJournal of the National Cancer Institute
dc.date.updated2020-08-28T00:20:25Z
curtin.note

© The Author(s) (2020). Published by Oxford University Press.

curtin.note

This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of the National Cancer Institute following peer review. The version of record McNeil, J.J. and Gibbs, P. and Orchard, S.G. and Lockery, J.E. and Bernstein, W.B. and Cao, Y. and Ford, L. et al. 2020. Effect of aspirin on cancer incidence and mortality in older adults. Journal of the National Cancer Institut is available online at: https://doi.org/10.1093/jnci/djaa114.

curtin.departmentSchool of Public Health
curtin.accessStatusOpen access
curtin.facultyFaculty of Health Sciences
curtin.contributor.orcidReid, Christopher [0000-0001-9173-3944]
dcterms.source.eissn1460-2105


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