The US Preventive Services Task Force (USPSTF) updated its recommendations on low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and the use of aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for prevention of colorectal cancer (CRC).1
Because CVD and CRC are major causes of death among US adults, the USPSTF sought to review and update its recommendations on aspirin use for the prevention of CVD events (2009) and aspirin and NSAID use for the prevention of CRC (2007).
The USPSTF updates include information from a review of 5 additional studies of aspirin use to prevent CVD events and several additional analyses of follow-up data on aspirin use for CRC prevention. In addition, commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms were also considered.
The recommendations call for initiating low-dose aspirin use as a primary preventive for CVD events and CRC in adults age 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 decision to initiate aspirin use in adults age 60 to 69 years should be an individual one. Persons in this age group who meet the above criteria are most likely to benefit. Those who value the potential benefits over the potential harms may also decide to initiate aspirin use.
Current evidence to assess the balance of benefits and harms of this use in adults younger than 50 years and adults 70 years or older are insufficient.
1. Bibbins-Domingo K; US Preventive Services Task Force. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: US Preventive Services Task Force recommendation statement [published online ahead of print April 12, 2016]. Ann Intern Med. doi:10.7326/M16-0577.