0
Summaries for Patients |

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: Recommendations From the U.S. Preventive Services Task Force FREE

[+] Article, Author, and Disclosure Information

This article was published at www.annals.org on 12 April 2016.


The full report is titled “Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement.” The author is K. Bibbins-Domingo, on behalf of the U.S. Preventive Services Task Force.


Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.

Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.


Ann Intern Med. 2016;164(12):I-22. doi:10.7326/P16-9015
© 2016 American College of Physicians
Text Size: A A A

12 42016.

Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Regular aspirin use can prevent cardiovascular disease (CVD) events (heart attack or stroke) in people with no previous CVD and decrease the chances of developing colorectal cancer (CRC). However, aspirin can cause serious bleeding in the digestive tract or brain. Balancing these different benefits and harms can be challenging. In 2009, the USPSTF recommended that men aged 45 to 79 years take aspirin if the chances of preventing heart attack outweighed the chances of bleeding and that women aged 55 to 79 years take aspirin if the chances of reducing stroke outweighed the chances of bleeding. At that time, the USPSTF also recommended that men younger than 45 years and women younger than 55 years who have not previously had a heart attack or stroke not take aspirin for prevention and that the balance of benefits and harms at age 80 years or older were unclear. In 2007, the USPSTF recommended against use of aspirin to prevent CRC in adults at average risk for CRC. The USPSTF wanted to update recommendations for using aspirin to prevent CVD and CRC based on new information.

How did the USPSTF develop these recommendations?

To update the 2009 and 2007 recommendations, the USPSTF reviewed 4 new studies of aspirin to prevent CVD, several additional analyses of CRC follow-up data, and a comprehensive review of studies of potential harms of aspirin use. The USPSTF then used a simulation model to estimate the balance of benefits and harms at various ages and risk levels.

What did the authors find?

Aspirin reduces the risk for CVD events in adults aged 50 to 69 years who are at risk for CVD. The benefit is moderate and varies by age and CVD risk.

Aspirin use reduces the risk for CRC in adults after 5 to 10 years of daily use.

Aspirin increases the risk for bleeding into the intestinal tract or brain, but the risks are small before age 59 years and are small to moderate for ages 60 to 69 years.

What does the USPSTF suggest that doctors and patients do?

Adults aged 50 to 59 years without CVD or CRC should use aspirin to prevent these conditions if they have a 10% or greater risk for CVD, are not at increased risk for bleeding, are expected to live at least 10 years, and are willing to take aspirin daily for at least 10 years.

The decision to use aspirin for preventing CVD and CRC in adults aged 60 to 69 years should be an individual one depending on patient preferences and discussion with a health care professional.

There is not enough evidence to recommend for or against using aspirin to prevent CVD and CRC in adults younger than 50 years or those aged 70 years or older.

What are the cautions related to these recommendations?

The USPSTF recognizes that clinical decisions involve more than evidence alone and should be individualized for the specific patent or situation.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)