What Long-Term Data Reveals About Aspirin and Cancer Risk
The recently published findings in JAMA Oncology, “Cancer Incidence and Mortality With Aspirin in Older Adults: Follow-Up of the ASPREE Trial,” show that taking a low-dose of daily aspirin does not reduce overall cancer rates in older adults, including colon cancer, but increases the risk of cancer-related mortality. Findings of this study suggest that starting a long-term aspirin strategy to prevent cancer is not recommended for older adults.
These research findings are significant because previous studies have suggested that taking aspirin reduces the risk of cancer after ten years, especially for colon cancer. These results reflect long-term findings from the ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial, conducted from 2010 to 2017 in the U.S. and Australia, and its follow-up, the ASPREE-eXTension (ASPREE-XT), conducted from 2018 to 2024. The primary research question for this analysis was to determine whether long-term low-dose daily aspirin could reduce the risk of cancer, especially colon cancer.
ASPREE was a longitudinal primary prevention aspirin trial funded by the National Institute on Aging, led by Monash University in Melbourne, Australia, and the Berman Center for Outcomes and Clinical Research at Hennepin Healthcare Research Institute. The study involved 19,000 participants in Australia and the United States over the age of 70 (65+ for U.S. Blacks or Hispanics).
ASPREE participants received a low dose of daily aspirin (100 mg) or a placebo pill to determine if the aspirin might prolong healthy lifespan, or dementia-and disability–free survival. All participants were asked to stop taking their trial aspirin or placebo pills at the end of the ASPREE trial and then switched to off-study medication during the ASPREE-XT follow-up study. Anne Murray, MD, MSc, Medical Director of the Berman Center, has been the U.S. Principal Investigator for ASPREE since 2015 and for its ongoing follow-up study, ASPREE-Long Term (ASPREE-LT), starting in September 2025.
Australian Director of ASPREE-XT study and Monash University Associate Professor, Suzanne Orchard, said, “Whilst we found overall no change in cancer incidence risk with aspirin when initiated in older age, we found cancer mortality remained significantly elevated by 15 per cent. However, the elevated cancer mortality risk seen with aspirin for participants in the original ASPREE trial period did not persist into the post-trial ASPREE-eXTension study, suggesting no lasting aspirin effect, although longer follow-up of the cohort is warranted.”
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