USPSTF: Update to Aspirin Use Guidelines

The U.S. Preventive Services Task Force (USPSTF) updated its 2009 recommendation on aspirin use to prevent cardiovascular disease (CVD) and its 2007 recommendation on aspirin and nonsteroidal anti-inflammatory drug use to prevent colorectal cancer.

To update the guidelines, the Task Force reviewed studies and analyses to better understand the efficacy of aspirin in preventing CVD and the all-cause mortality, total cancer incidence, and mortality rates of patients with colorectal cancer, as well as a review of its harms.
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They then evaluated the benefits and harms by using a microsimulation model.

As a result, the USPSTF determined that patients aged 50 to 59 years would benefit the most from a low-dose, daily aspirin regimen. Other recommendations included the following:

  • Initiate a low-dose aspirin regimen for the primary prevention of CVD and colorectal cancer in adults aged 50 to 59 years who have a 10% or higher risk of CVD, 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.
  • Practitioners should decide whether a low-dose aspirin regimen is right for their patients aged 60 to 69 years who have a 10% or higher CVD risk over 10 years. A low-dose aspirin regimen is most beneficial to those aged 60 to 69 years who are not at an 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 evidence was insufficient to assess the benefits and harms of aspirin use for preventing CVD and colorectal cancer in adults younger than 50 years and adults 70 years or older.

—Amanda Balbi

Reference:
Bibbins-Domingo K. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recommendation statement [published April 12, 2016]. Ann Intern Med. doi:10.7326/M16-0577.