Observational studies and randomised trials indicate that long-term aspirin use can reduce incidence and mortality from colorectal cancer; however, evidence from randomised trials about other cancers is limited. Peter Rothwell and colleagues, in The Lancet, provide important new evidence that long-term daily aspirin lowers mortality from several cancers other than colorectal cancer, and could have a meaningful effect on overall cancer mortality. In a pooled analysis, including the intervention periods of eight randomised trials that lasted up to 9 years, cancer mortality was 21% lower in the aspirin group than in the control group, driven mainly by a 34% reduction in cancer mortality after the first 5 years of follow-up. In a longer-term analysis, including 20 years of follow-up from the intervention and post-intervention periods of three of the eight trials, cancer mortality was 22% lower in participants randomised to receive aspirin for 5-9 years than in those not randomised to aspirin.
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