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Prophylactic aspirin and public

NHS Wales Policy Lead for Older People, NHS Wales, 13 Goring Road, Llanelli, Carmarthenshire, Wales, SA15 3HF, UK

The clinical use of aspirin, first synthesized over 100 years ago, entered a new phase in 1974 with the reporting of the first randomised trial showing a reduction in vascular disease deaths from low-doses. More recent evidence suggests that the medicine is effective against cancer, which makes aspirin of very considerable potential importance to public health improvement and potentially also to clinical practice. It appears that prophylactic aspirin is being increasingly used throughout the community. There is need therefore for the risks and benefits of low-dose aspirin, and its' role within healthcare and within public health, to be widely discussed not least as media reports are bringing this issue into the public domain. It also follows that policy decisions need to be taken as to whether or not its use should be actively promoted. In particular, it is important that Doctors and healthcare practitioners are well informed of the risks and benefits so that they can impart this knowledge during consultations. Furthermore, it is important that low-dose aspirin is not perceived as a substitute for a healthy lifestyle, but that it is recommended and uptake monitored alongside other protective behaviours to improve on health gain, such as smoking cessation, moderate alcohol intake, exercise and diet.
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1. Elwood, P. ; Longley, M. (2010) My health: whose responsibility?: A Jury decides. J Epidemiol Commun H 64: 761-764.    

2. Antithrombotic, T. (2009) Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 373:1849-1860.    

3. Elwood, P. ; Morgan, G. ; Fone, D. et al. (2011) Aspirin use in a south-Wales county. Br J Cardiol 18: 238-240.

4. Morgan, G. (2012) Rapid health impact assessment of aspirin promotion for the secondary prophylaxis of vascular events in Wales. Qual Prim Care 20: 299-301.

5. Elwood, P. ; Gallagher, A. M. ; Duthie, G. G. et al. (2008) Aspirin, salicylates and cancer. Lancet373: 1301-1309.

6. Rothwell, P. M; Wilson, M. ; Elwin, C. E. et al. (2010) Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet 376: 1741-1750.    

7. Rothwell, P. M; Fowkes, F. G. R; Belch, J. F. F. et al. (2011) Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet377: 31-41.

8. Burn, J. ; Gerdes, A. M. ; Macrae, F. et al. (2011) Long-term effect of aspirin on cancer risk in carriers of hereditary colorectal cancer: an analysis from the CAPP2 RCT. Lancet 378: 281-287.

9. Phillips, I. ; Langley, R. ; Gilbert, D. ; et al. (2013) Aspirin as a treatment for cancer. Clin Oncol (R Coll Radiol) 25: 333-335.    

10. Morgan, G. ; Elwood, P. (2009) Could recommendations about aspirin prophylaxis enhance colorectal cancer screening programmes? Eur J Public Health 19: 576-577.    

11. Morgan, G. (2009) Aspirin for the prevention of vascular events. Public Health 123: 787-788.    

12. Gorelick, P. B. ; Weisman, S. M. (2005) Risk of haemorrhagic stroke with aspirin use: an update. Stroke 36: 1801-1807.    

13. Hansson, L. ; Zanchetti, A. ; Carruthers, S. G. et al. (1998) Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. HOT Study Group. Lancet 351:1755-1762.

14. Elwood, P. ; Morgan, G. ; Brown, G. ; et al. (2005) Aspirin for all over 50? For. British Medical Journal 330: 1440-1441.    

15. Baigent, C. ; (2005) Aspirin for all over 50? Against. British Medical Journal 330: 1441-1442.

16. Baron, J. A. (2003) A randomized trial of aspirin to prevent colorectal adenomas. N Engl J Med348:891-899.

17. Chan, A. T. ; Giconnucci, E. L. ; Schernhammer, E. S. et al. (2004) A prospective study of aspirin use and the risk for colorectal adenoma. Ann Intern Med 140: 157-166.    

18. Brenner, H. ; Tao, S. ; Haug, U. (2010) Low-dose aspirin use and performance of immunochemical fecal occult blood tests. JAMA 304: 2513-2520.    

19. Ajani, U. A. ; Ford, E. S. ; Greenland, K. J. (2006) Aspirin use among US adults: Behavioural Risk Factor Surveillance System. Amer J Prev Med 30: 74-77.    

20. Sung, J. J. ; Lau, J. Y. ; Ching, J. Y. et al. (2010) Continuation of low-dose aspirin therapy in peptic ulcer bleeding: a randomized trial. Ann Intern Med 152: 1-9.    

21. US Preventive Services Task Force. (2009) Aspirin for the prevention of cardiovascular disease: US preventive services task force recommendation statement. Ann Intern Med 150: 396-404.    

Copyright Info: © 2014, Gareth Morgan, licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

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