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Aspirin in the elderly associated with increased risk of metastatic cancer

The use of aspirin in elderly patients appears to increase the risk of incident solid cancers presenting at an advanced stage according to the results of a new study.

Researchers from Monash University, Australia, randomised 19,114 individuals aged 70 years and older, without cardiovascular disease, dementia or physical disability to either enteric coated aspirin 100mg daily or matching placebo and followed them for a median of 4.7 years.

The results showed that during the trial, 1933 (10%) individuals developed a cancer, with prostate, colorectal, breast, melanoma and lung, accounting for over 80% of all solid organ cancers. Use of aspirin was not associated with the risk of developing cancer (hazard ratio, HR = 1.04, 95% CI 0.95–1.14). However, aspirin use was associated with metastatic cancer at diagnosis (HR = 1.19, 95% CI 1–1.43) and with an increased incidence of cancers presenting at stage 4 (HR = 1.22, 95% CI 1.02–1.45). Furthermore, there was an increased progression to death among those taking aspirin, regardless of whether the initial cancer had been localised or metastatic.

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The authors concluded that aspirin appeared to increase the risk of cancer evolution in older adults and reported that they are continuing the follow the cohort to examine the impact of aspirin in the longer term.

McNeal JJ et al. Effect of aspirin on cancer incidence and mortality in older adults. J Natl Cancer 2020; Aug 11: