Aspirin and cancer treatment: systematic reviews and meta-analyses of evidence: for and against

Elwood, Peter, Morgan, Gareth, Watkins, John, Protty, Majd, Mason, Malcolm ORCID: https://orcid.org/0000-0003-1505-2869, Adams, Richard ORCID: https://orcid.org/0000-0003-3915-7243, Dolwani, Sunil ORCID: https://orcid.org/0000-0002-3113-5472, Pickering, Janet, Delon, Christine and Longley, Marcus 2024. Aspirin and cancer treatment: systematic reviews and meta-analyses of evidence: for and against. British Journal of Cancer 130 , pp. 3-8. 10.1038/s41416-023-02506-5

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Abstract

Aspirin as a possible treatment of cancer has been of increasing interest for over 50 years, but the balance of the risks and benefits remains a point of contention. We summarise the valid published evidence ‘for’ and ‘against’ the use of aspirin as a cancer treatment and we present what we believe are relevant ethical implications. Reasons for aspirin include the benefits of aspirin taken by patients with cancer upon relevant biological cancer mechanisms. These explain the observed reductions in metastatic cancer and vascular complications in cancer patients. Meta-analyses of 118 observational studies of mortality in cancer patients give evidence consistent with reductions of about 20% in mortality associated with aspirin use. Reasons against aspirin use include increased risk of a gastrointestinal bleed though there appears to be no valid evidence that aspirin is responsible for fatal gastrointestinal bleeding. Few trials have been reported and there are inconsistencies in the results. In conclusion, given the relative safety and the favourable effects of aspirin, its use in cancer seems justified, and ethical implications of this imply that cancer patients should be informed of the present evidence and encouraged to raise the topic with their healthcare team.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Springer Nature
ISSN:	0007-0920
Date of First Compliant Deposit:	15 January 2024
Date of Acceptance:	13 November 2023
Last Modified:	06 Feb 2024 12:11
URI:	https://orca.cardiff.ac.uk/id/eprint/165181

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