Key Evidence

Crucial Studies on Aspirin for Disease Prevention

Following guideline recommendations is important; understanding the evidence behind the recommendations is critical. In this section of, you will find summaries of several studies that are the basis of the USPSTF recommendations.

We also have selected additional research studies that have been reported since the 2009 USPSTF guidelines were developed. We believe that by reviewing and evaluating the relevant primary aspirin literature, you can better bring your own unique clinical judgment and point of view to the decision of prescribing aspirin for the primary prevention of heart disease, stroke and cancer.

Aspirin-related bleeding in patients with and without diabetes.

Aspirin users are at increased risk of major bleeding. Diabetic patients are at increased risk of major bleeding, although this risk is not increased with use of aspirin.

Alternate-day, low-dose aspirin use and cancer risk

Every other day use of aspirin reduces colorectal cancer risk, but this benefit should be weighed against the increased risk of gastrointestinal bleeding.

Benefits and harms of prophylactic use of aspirin in the general population.

Long term use of aspirin reduces the occurrence of cancer as well as death from cancer based on a new analysis of recent research studies.

Effects of aspirin on recurrence of colorectal tumors in Asian patients

Aspirin effectively reduces the recurrence of colorectal tumors in Asian populations, which is consistent with the results of similar studies in Western countries.

The use of pain relief medications and the risk of ovarian cancer.

Aspirin reduces the risk of ovarian cancer at low-dose, whereas other nonsteroidal anti-inflammatory drugs (NSAIDs) may be effective only at higher doses.

Low-dose aspirin for primary prevention of cardiovascular events in older Japanese with risk factors.

Low-dose daily aspirin did not reduce the risk of cardiovascular events such as death, hearth attack and stroke.

The U.S. Preventive Services Task Force recommendations for aspirin use in the prevention of cardiovascular disease

This article describes the most current (2009) recommendations for the use of aspirin in the primary prevention of heart disease and stroke among those who have never had a heart attack or stroke.

Updated evidence for the 2009 U.S. Preventive Services Task Force aspirin recommendations

Based on past clinical trials, this article examines the benefits and harms of taking aspirin for the primary prevention of heart attacks, strokes and cardiovascular death. This synthesis provides the evidence that guided the 2009 U.S. Preventive Services Task Force recommendations.

Guidelines for the role of aspirin in the primary prevention of stroke

These recommendations on stroke prevention incorporate evidence on both established and emerging risk factors.

Benefits and harms of aspirin use in men and women for cardiovascular disease prevention from a gender-specific meta-analysis of clinical trials

The authors combined information from six key randomized controlled trials conducted between 1966 and 2005 to determine the overall benefits and harms of aspirin use in persons with no known heart disease. They found significant difference in benefits and harms by gender.

Short-term effects of daily aspirin on cancer incidence and mortality in 51 randomized controlled trials

This study reviews the increasingly strong evidence that aspirin prevents colorectal cancer and cancer-related deaths, especially in patients who have taken aspirin for more than five years.

Aspirin prevents cognitive decline in women in a 5-year study of non-demented elderly women

This study of elderly Swedish women shows that in addition to its effects on cardiovascular risk and cancer mortality, aspirin may also help prevent cognitive decline in older women.

Cost-effectiveness of using aspirin for the primary prevention of cardiovascular disease in women

In this article, the authors created a mathematical model to help identify groups of women where aspirin use is cost-effective (essentially which groups receive the greatest benefits from aspirin use).

Advantages of informing patients of their cardiovascular disease risk

The authors of this review article evaluated whether providing patients with an estimation of their cardiovascular disease risk, using one or more of the available risk assessment tools, improves health knowledge, motivation and risk factor control.

Benefits and harms of aspirin use in individuals with and without a prior stroke or heart attack

The authors analyzed the current clinical trial evidence and suggest that the benefits of aspirin therapy greatly outweigh its harms in patients with a prior heart attack or stroke. The balance of benefits and harms of aspirin in patients who have not had a prior heart attack or stroke is uncertain.

Review and analysis of the most effective preventive services

Among all preventive strategies examined in this study, three services – aspirin use, tobacco counseling and childhood immunization – were prioritized based on their potential for reducing both health burden and health care costs.

Cost-effectiveness of aspirin and statin medications for the primary prevention of heart disease in men

This article presents a computer model to evaluate the potential benefits and harms of using aspirin and statin medications, either individually or together.

Aspirin’s impact on prostate cancer risk at the population level

This study of Finnish men suggests that aspirin use may be protective against the development of prostate cancer.

Aspirin reduces the risk of developing colorectal cancer

This review of past studies suggests that aspirin leads to a reduction in the risk of colorectal cancer. Deaths from all cancers were less likely in patients who had taken aspirin for at least four years.

Cost-effectiveness of including cancer prevention in decisions on aspirin therapy

This article’s authors incorporate the colon cancer reduction benefits of aspirin into a statistical model to help determine whether this expands the number of people likely to receive benefits that outweigh harms.