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1. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer

Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer 1 Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer Interim Guidance from the Kaiser Permanente National Integrated Cardiovascular Health (ICVH) Work Group October 5, 2018 Three randomized clinical trials (ARRIVE 1 , ASCEND 2 , and ASPREE 3 ) recently published results on aspirin use in patients without known Atherosclerotic Cardiovascular Disease (ASCVD). The studies looked at benefits including (...) cardiovascular event prevention, and risks including serious bleeding events. Overall the studies suggest that aspirin lacks net benefit (total benefits minus total harms) beyond age 70, and there is low net benefit in younger adults. USPSTF 2016 aspirin recommendations point to highest net benefit for aspirin in adults age 50-59 (lower bleeding risk than older patients) with 10-year ASCVD risk* >10%. The National Kaiser Permanente Aspirin recommendations will be formally updated following a comprehensive

2019 Kaiser Permanente National Guideline Program

2. Aspirin use for the prevention of colorectal cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force

Aspirin use for the prevention of colorectal cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force Aspirin use for the prevention of colorectal cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force Aspirin use for the prevention of colorectal cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force Chubak J, Kamineni A, Buist DS, Anderson ML, Whitlock EP Record Status This is a bibliographic (...) record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Chubak J, Kamineni A, Buist DS, Anderson ML, Whitlock EP. Aspirin use for the prevention of colorectal cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force. Rockville: Agency for Healthcare Research and Quality (AHRQ). Evidence Synthesis No. 133. 2015 Authors' objectives We conducted

2015 Health Technology Assessment (HTA) Database.

3. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication

Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication Final Update Summary: Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication - US Preventive Services Task Force Search USPSTF Website Text size: Assembly version: 1.0.0.308 Last Build: 11/16/2018 6:27:19 PM You are here: Final Summary Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication Release Date: April 2016 Recommendation (...) Summary Population Recommendation Grade Adults aged 50 to 59 years with a ≥10% 10-year CVD risk The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in 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. Adults aged 60 to 69 years with a ≥10

2016 U.S. Preventive Services Task Force

4. EffectiveNess of Low-dose Aspirin in Prevention of Cancer in the Stomach and Oesophagus (GastrointEstinal Cancer Prevention)

EffectiveNess of Low-dose Aspirin in Prevention of Cancer in the Stomach and Oesophagus (GastrointEstinal Cancer Prevention) EffectiveNess of Low-dose Aspirin in Prevention of Cancer in the Stomach and Oesophagus (GastrointEstinal Cancer Prevention) - United Kingdom ("ENgAGE - UK"): Study to Evaluate the Risk of Cancer in the Stomach and Oesophagus Among New Users of Low-dose Aspirin Using the THIN Database in the UK - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record (...) managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. EffectiveNess of Low-dose Aspirin in Prevention of Cancer in the Stomach and Oesophagus (GastrointEstinal Cancer Prevention) - United Kingdom ("ENgAGE - UK"): Study to Evaluate the Risk of Cancer in the Stomach and Oesophagus Among New

2018 Clinical Trials

5. Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews

Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews DOI 10.3310/hta17430 Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews P Sutcliffe, M Connock, T Gurung, K Freeman, S Johnson, N-B Kandala, A Grove, B Gurung, S Morrow and A Clarke HEALTH TECHNOLOGY ASSESSMENT VOLUME 17 ISSUE 43 SEPTEMBER 2013 ISSN 1366-5278Aspirin (...) , Freeman K, Johnson S, Kandala N-B, et al. Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer: a systematic review and overview of reviews. Health Technol Assess 2013;17(43). Health Technology Assessment is indexed and abstracted in Index Medicus/MEDLINE, Excerpta Medica/EMBASE, Science Citation Index Expanded (SciSearch ® ) and Current Contents ® / Clinical Medicine.Health Technology Assessment NICE TAR and DAR ISSN 1366-5278 (Print) ISSN 2046-4924 (Online

2013 NIHR HTA programme

6. Aspirin use to prevent cardiovascular disease and cancer: a decision analysis

Aspirin use to prevent cardiovascular disease and cancer: a decision analysis Aspirin use to prevent cardiovascular disease and cancer: a decision analysis Aspirin use to prevent cardiovascular disease and cancer: a decision analysis Dehmer SP, Maciosek MV, Flottemesch, TJ Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Dehmer SP (...) , Maciosek MV, Flottemesch, TJ. Aspirin use to prevent cardiovascular disease and cancer: a decision analysis. Rockville: Agency for Healthcare Research and Quality (AHRQ). AHRQ Publication No. 15-05229-EF-1. 2015 Authors' objectives To assess the net balance of benefits and harms from routine use of aspirin for primary prevention across clinically relevant age, sex, and cardiovascular disease (CVD) risk groups. Authors' conclusions Benefits are predicted to exceed harms among persons aged 40-69

2015 Health Technology Assessment (HTA) Database.

7. Aspirin use in adults: cancer, all cause mortality, and harms. A systematic evidence review for the U.S. Preventive Services Task Force

Aspirin use in adults: cancer, all cause mortality, and harms. A systematic evidence review for the U.S. Preventive Services Task Force Aspirin use in adults: cancer, all cause mortality, and harms. A systematic evidence review for the U.S. Preventive Services Task Force Aspirin use in adults: cancer, all cause mortality, and harms. A systematic evidence review for the U.S. Preventive Services Task Force Whitlock EP, Williams SB, Burda BU, Feightner A, Beil T Record Status (...) This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Whitlock EP, Williams SB, Burda BU, Feightner A, Beil T. Aspirin use in adults: cancer, all cause mortality, and harms. A systematic evidence review for the U.S. Preventive Services Task Force. Rockville: Agency for Healthcare Research and Quality (AHRQ). Evidence Synthesis No. 132. 2015 Authors' objectives We conducted

2015 Health Technology Assessment (HTA) Database.

8. Systematic review of aspirin in the prevention of hereditary and sporadic colorectal adenoma and cancer

Systematic review of aspirin in the prevention of hereditary and sporadic colorectal adenoma and cancer Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO

9. Aspirin for primary prevention of cancer: an updated systematic review and subgroup meta-analysis of prospective randomized controlled trials (RCTs)

Aspirin for primary prevention of cancer: an updated systematic review and subgroup meta-analysis of prospective randomized controlled trials (RCTs) Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

10. Aspirin Prevention of Colorectal Cancer: Focus on NF-κB Signalling and the Nucleolus Full Text available with Trip Pro

Aspirin Prevention of Colorectal Cancer: Focus on NF-κB Signalling and the Nucleolus Overwhelming evidence indicates that aspirin and related non-steroidal anti-inflammatory drugs (NSAIDs) have anti-tumour activity and the potential to prevent cancer, particularly colorectal cancer. However, the mechanisms underlying this effect remain hypothetical. Dysregulation of the nuclear factor-kappaB (NF-κB) transcription factor is a common event in many cancer types which contributes to tumour (...) initiation and progression by driving expression of pro-proliferative/anti-apoptotic genes. In this review, we will focus on the current knowledge regarding NSAID effects on the NF-κB signalling pathway in pre-cancerous and cancerous lesions, and the evidence that these effects contribute to the anti-tumour activity of the agents. The nuclear organelle, the nucleolus, is emerging as a central regulator of transcription factor activity and cell growth and death. Nucleolar function is dysregulated

2017 Biomedicines

11. Study to Evaluate How Patients Regard the Benefits and Risks of Low-dose Aspirin for the Prevention of Heart and Blood Vessels Disease and for the Prevention of Cancer of the Colon and Rectum

Study to Evaluate How Patients Regard the Benefits and Risks of Low-dose Aspirin for the Prevention of Heart and Blood Vessels Disease and for the Prevention of Cancer of the Colon and Rectum Study to Evaluate How Patients Regard the Benefits and Risks of Low-dose Aspirin for the Prevention of Heart and Blood Vessels Disease and for the Prevention of Cancer of the Colon and Rectum - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting (...) registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Study to Evaluate How Patients Regard the Benefits and Risks of Low-dose Aspirin for the Prevention of Heart and Blood Vessels Disease and for the Prevention of Cancer of the Colon and Rectum The safety and scientific validity of this study is the responsibility of the study

2018 Clinical Trials

12. Aspirin did not prevent deaths or disability in healthy older adults

their mortality and bleeding risk - aspirin was associated with an excess of 1.6 deaths per 1,000 people per year. Half of these deaths were due to cancer. Aspirin is an established ‘secondary’ preventative treatment for people who have known cardiovascular disease. However, the risk-benefit balance of aspirin for ‘primary’ prevention in people without known cardiovascular disease is debated. This large trial enrolled over 19,000 community-dwelling adults aged over 70 years and assigned them to aspirin (...) – at the dose of 100mg – or matching placebo. The cancer association is unexpected and is at odds with most other research suggesting aspirin might decrease cancer risk, or be neutral. So, with only five years follow-up, this finding needs cautious interpretation at this stage. Nevertheless, this research supports guideline recommendations which do not include aspirin as part of primary prevention in older people. Share your views on the research. Why was this study needed? Cardiovascular disease

2019 NIHR Dissemination Centre

13. Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial. Full Text available with Trip Pro

Eicosapentaenoic acid and aspirin, alone and in combination, for the prevention of colorectal adenomas (seAFOod Polyp Prevention trial): a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial. The omega-3 polyunsaturated fatty acid eicosapentaenoic acid (EPA) and aspirin both have proof of concept for colorectal cancer chemoprevention, aligned with an excellent safety profile. Therefore, we aimed to test the efficacy of EPA and aspirin, alone and in combination (...) and compared with a placebo, in individuals with sporadic colorectal neoplasia detected at colonoscopy.In a multicentre, randomised, double-blind, placebo-controlled, 2 × 2 factorial trial, patients aged 55-73 years who were identified during colonoscopy as being at high risk in the English Bowel Cancer Screening Programme (BCSP; ≥3 adenomas if at least one was ≥10 mm in diameter or ≥5 adenomas if these were <10 mm in diameter) were recruited from 53 BCSP endoscopy units in England, UK. Patients were

2018 Lancet Controlled trial quality: predicted high

14. The effect of low-dose aspirin on colorectal cancer prevention and gastrointestinal bleeding according to bodyweight and body mass index: Analysis of UK primary care data. Full Text available with Trip Pro

The effect of low-dose aspirin on colorectal cancer prevention and gastrointestinal bleeding according to bodyweight and body mass index: Analysis of UK primary care data. Meta-analysis of trial data suggests that in primary cardiovascular disease (CVD) prevention bodyweight modifies low-dose aspirin's effects on colorectal cancer (CRC) and major bleeding risk. We sought to investigate whether these effects are seen in patients with or without CVD in routine clinical practice by undertaking sub (...) (0.50-0.72) for ≤70 kg, 0.68 (0.60-0.76) for >70 kg; and by BMI were 0.60 (0.52-0.68) for ≤28 kg/m2, 0.76 (0.64-0.89) for >28 kg/m2. For UGIB, estimates were: 1.49 (1.28-1.74) for ≤90 kg, 1.78 (1.29-2.45) for >90 kg/m2, 1.44 (1.21-1.72) for ≤28 kg/m2, 1.72 (1.38-2.16) for >28 kg/m2. Results were similar in the primary CVD prevention population.Our findings suggest that the effects of low-dose aspirin in reducing CRC risk and increasing UGIB risk are not modified by bodyweight/BMI.Copyright © 2019

2019 International journal of cardiology

15. Aspirin for primary prevention: USPSTF recommendations for CVD and colorectal cancer. (Abstract)

Aspirin for primary prevention: USPSTF recommendations for CVD and colorectal cancer. Patient age, baseline cardiovascular disease risk, bleeding risk, and personal preference regarding aspirin use are key to decision making. A clinical decision tool can help.

2019 Journal of Family Practice

16. Long-term aspirin use for cancer primary prevention: A protocol for updated systematic review and subgroup meta-analysis of randomized clinical trials. Full Text available with Trip Pro

Long-term aspirin use for cancer primary prevention: A protocol for updated systematic review and subgroup meta-analysis of randomized clinical trials. Long-term use of aspirin for primary prevention of cancer remains inconclusive, and variation in the effects of aspirin use on cancer outcomes by cancer site, aspirin dose, follow-up duration, or different populations has never been systematically evaluated.Seven electronic databases (PubMed, EMBASE, ClinicalTrials.gov, etc) will be searched (...) mortality, all-cause mortality, and the risk of major bleeding. Subgroup analyses will indicate whether the effects of aspirin on cancer outcomes are associated with cancer site, daily dose of aspirin, follow-up duration, or different subgroup of participants. The results will be submitted and published in a peer-reviewed scientific journal.This systematic review will systematically evaluate the efficacy and safety of long-term use of aspirin for primary prevention of cancer and determine whether

2019 Medicine

17. Aspirin does not prevent pancreatic cancer in a large Asian cohort. (Abstract)

Aspirin does not prevent pancreatic cancer in a large Asian cohort. Evidence has suggested that aspirin reduces the incidence of several cancers, but these benefits may not occur with pancreatic cancer.A 12-year nationwide longitudinal cohort merged with health checkup data were divided into "exposure ascertainment period" and "outcome ascertainment period" to avoid immortal time bias. The Daily Defined Dose system was used to indicate the drug exposure.We found no significant association (...) between aspirin use and incident pancreatic cancer based on hazard ratio.Aspirin dose not prevent pancreatic cancer.A large Asian cohort study with reliable medication information affirm no impact of aspirin on pancreatic cancer development.Copyright ©2019, American Association for Cancer Research.

2019 Cancer Epidemiology & Biomarkers and Prevention

18. Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer Full Text available with Trip Pro

Understanding why aspirin prevents cancer and why consuming very hot beverages and foods increases esophageal cancer risk. Controlling the division rates of stem cells is an important strategy to prevent cancer Cancer is, in essence, a stem cell disease. The main biological cause of cancer is that stem cells acquire DNA alterations during cell division. The more stem cell divisions a tissue accumulates over a lifetime, the higher is the risk of cancer in that tissue. This explains why cancer (...) is diagnosed millions of times more often in some tissues than in others, and why cancer incidence increases so dramatically with age. It may also explain why taking a daily low-dose aspirin for several years reduces the risk of developing and dying from cancer. Since aspirin use reduces PGE2 levels and PGE2 fuels stem cell proliferation, aspirin may prevent cancer by restricting the division rates of stem cells. The stem cell division model of cancer may also explain why regular consumption of very hot

2015 Oncoscience

19. Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales

Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales Cost-effectiveness comparison of breast cancer screening and vascular event primary prevention with aspirin in Wales Morgan G Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study assessed the cost-effectiveness of a health education programme plus aspirin for the primary prevention of vascular events in the general population aged 50 years or older, and compared this with the cost-effectiveness of breast cancer screening. The results supported the implementation of an education programme

2012 NHS Economic Evaluation Database.

20. Predicting Bleeding Risk to Guide Aspirin Use for the Primary Prevention of Cardiovascular Disease: A Cohort Study. (Abstract)

Predicting Bleeding Risk to Guide Aspirin Use for the Primary Prevention of Cardiovascular Disease: A Cohort Study. Many prognostic models for cardiovascular risk can be used to estimate aspirin's absolute benefits, but few bleeding risk models are available to estimate its likely harms.To develop prognostic bleeding risk models among persons in whom aspirin might be considered for the primary prevention of cardiovascular disease (CVD).Prospective cohort study.New Zealand primary care.The study (...) of high numbers of missing values, and the models were not externally validated in non-New Zealand populations.Prognostic bleeding risk models were developed that can be used to estimate the absolute bleeding harms of aspirin among persons in whom aspirin is being considered for the primary prevention of CVD.The Health Research Council of New Zealand.

2019 Annals of Internal Medicine

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