Evidence map›Paper›PMID 32778876›Full record

ArticleJournal of the National Cancer Institute2021

Effect of Aspirin on Cancer Incidence and Mortality in Older Adults.

John J McNeil, Peter Gibbs, Suzanne G Orchard, Jessica E Lockery, Wendy B Bernstein, Yin Cao, Leslie Ford, Andrew Haydon, Brenda Kirpach, Finlay Macrae and 18 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 101 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 7 pooled it
7.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 7 syntheses or guidelines pooled it, 140 citations in OpenAlex.

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  2. The Anti-Metastatic Role of Aspirin in Cancer: A Systematic Review.International journal of molecular sciences · 2026
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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 14 institutions in 2 countries.

John J McNeilDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Peter GibbsThe Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; and Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Suzanne G OrchardDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Jessica E LockeryDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Wendy B BernsteinWalter Reed National Military Medical Center, Bethesda, MD, USA.
Yin CaoDivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Leslie FordDivision of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
Andrew HaydonDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Brenda KirpachBerman Center for Outcomes and Clinical Research, Hennepin Health Research Institute, Hennepin, HealthCare, Minneapolis, MN, USA.
Finlay MacraeDepartment of Medicine, University of Melbourne, Melbourne, Victoria, Australia; and Department of Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Catriona McLeanDepartment of Anatomical Pathology, Alfred Hospital, Melbourne, Victoria, Australia.
Jeremy MillarDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Anne M MurrayBerman Center for Outcomes and Clinical Research, Hennepin Health Research Institute, Hennepin, HealthCare, Minneapolis, MN, USA.
Mark R NelsonDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Galina PolekhinaDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Christopher M ReidDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Ellen RichmondDivision of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
Luz Maria RodríguezWalter Reed National Military Medical Center, Bethesda, MD, USA.
Raj C ShahDepartment of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
Jeanne TieThe Walter & Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia; and Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Asad UmarDivision of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
G J van LondenDepartment of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
Kathlyn RonaldsonDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Rory WolfeDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Robyn L WoodsDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
John ZalcbergDepartment of Epidemiology & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Andrew T ChanClinical and Translational Epidemiology Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
ASPREE Investigator Group
Monash University · AUNational Cancer Institute · USWalter and Eliza Hall Institute of Medical Research · AUWalter Reed National Military Medical Center · USBerman Center for Outcomes and Clinical Research · USCurtin University · AUMassachusetts General Hospital · USRush University Medical Center · USThe Alfred Hospital · AUThe Royal Melbourne Hospital · AUUniversity of Minnesota · USUniversity of Pittsburgh · USUniversity of Tasmania · AUWashington University in St. Louis · US

Funding

ASPirin in Reducing Events in the ElderlyU01AG029824 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MCNEIL, JOHN JAMES, MURRAY, ANNE M · 2009 to 2018
$64.6M
Research Education CoreP30AG024824 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Neil Alexander · 2004 to 2026
$29.2M
UTMB OAIC Research Education Component (REC)P30AG024832 · NIA · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI JAMES S. GOODWIN, MD, MELISSA M. MORROW · 2005 to 2026
$26.7M
Optimizing the Impact of Aspirin for ChemopreventionK07CA218377 · NCI · WASHINGTON UNIVERSITY · PI CAO, YIN · 2018 to 2021
$504k
NCI NIH HHS K07 CA218377NIA NIH HHS P30 AG024824NIA NIH HHS P30 AG024832NIA NIH HHS U01 AG029824
6 · The paper itself

Abstract

backgroundASPirin in Reducing Events in the Elderly, a randomized, double-blind, placebo-controlled trial of daily low-dose aspirin (100 mg) in older adults, showed an increase in all-cause mortality, primarily due to cancer. In contrast, prior randomized controlled trials, mainly involving younger individuals, demonstrated a delayed cancer benefit with aspirin. We now report a detailed analysis of cancer incidence and mortality.

methods19 114 Australian and US community-dwelling participants aged 70 years and older (US minorities 65 years and older) without cardiovascular disease, dementia, or physical disability were randomly assigned and followed for a median of 4.7 years. Fatal and nonfatal cancer events, a prespecified secondary endpoint, were adjudicated based on clinical records.

results981 cancer events occurred in the aspirin and 952 in the placebo groups. There was no statistically significant difference between groups for all incident cancers (hazard ratio [HR] = 1.04, 95% confidence interval [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).

conclusionsIn 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.

Indexed as

AgedAged, 80 and overAge FactorsAnti-Inflammatory Agents, Non-SteroidalAspirinAustraliaFemaleHumansIncidenceMaleMortalityNeoplasmsProportional Hazards ModelsRandomized Controlled Trials as TopicUnited StatesAnti-Inflammatory Agents, Non-SteroidalAspirin

Identifiers

PMID32778876
PMCPMC7936068
OpenAlexW3048728071

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.