Aspirin to Prevent Colon Cancer

In September 2015, the US Preventive Services Task Force (USPSTF) posted its draft recommendation statement on the use of aspirin to prevent cancer and cardiovascular disease (CVD). The USPSTF, created in 1984, is an independent volunteer panel of national experts in prevention and evidence-based medicine. The draft is posted on the organization’s website, www.uspreventiveservicestaskforce.org, and the deadline for public comments about the draft statement is October 12, 2015.

The USPSTF recommends low-dose aspirin use for the primary prevention of colorectal cancer and CVD for adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years. The task force recommends that a decision to use low-dose aspirin to prevent CVD and colorectal cancer in adults aged 60 to 69 years who have a greater than 10% 10-year CVD risk should be an individual one. People who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take low-dose aspirin daily for at least 10 years are more likely to benefit.

The current evidence is insufficient to assess the balance of benefits and harms of aspirin use to prevent CVD and colorectal cancer in adults younger than age 50 years and older than age 70. The prevention of colorectal cancer plays an important role in the overall health benefit of aspirin, but this benefit is not apparent until 10 years after starting aspirin. Aspirin needs to be taken for at least 5 to 10 years to realize potential benefit. People with shorter life expectancies are less likely to realize this benefit; consequently, aspirin use is more likely to have an impact when it is started between the ages of 50 and 59 years.