Abstract PL05-03: Progress towards routine use of aspirin by people at increased risk of cancer

Abstract

Abstract A consistent result of cohort, case control, post-trial follow up and randomized controlled trials into the antineoplastic effects of aspirin is that this agent has a major protective effect. It is ubiquitous and cheap and has the longest safety record of any drug in widespread use. Despite this, proposals for widespread use meet resistance which could be seen as disproportionate. Historic over use leading to a global awareness of adverse events, academic clinical biases, commercial competition and a contempt for the familiar may all be invoked; “I went to see a specialist and all he said was take an aspirin!” The lesson from the anti-smoking lobby is to just keep pressing. Our CAPP2 study revealed an impressive effect of aspirin even in hereditary cancer (Burn et al 2011) and subsequent data reinforce this. The 600mg dose used was in the sub-analgesic range and there were minimal adverse events but the perception of “great risk” justifies CaPP3 which will be a 7 year long dose non-inferiority study comparing 600mg, 300mg or 100mg doses daily as a blinded intervention in at least 3000 proven carriers of a mismatch repair gene defect. Public and professional education should continue in parallel to emphasize the benefits of H pylori eradication, acid suppressants and anti-hypertensives in minimizing adverse events which may, even without such measures, be considered tolerable in the context, at least, of those at increased statistical risk due to a positive family history of solid tumors. Citation Format: John Burn. Progress towards routine use of aspirin by people at increased risk of cancer. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr PL05-03.