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NICE recommends aspirin for cancer prevention for the first time

The National Institute for Health and Care Excellence has recommended in draft guidance that people who have Lynch Syndrome take aspirin daily to reduce the risk of colorectal cancer.

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Aspirin has been recommended for cancer prevention in draft guidance from the National Institute for Health and Care Excellence for the first time

Aspirin has been recommended for cancer prevention in national clinical guidance for the first time.

Taking aspirin daily can help prevent people who have the inherited genetic condition Lynch Syndrome from developing colorectal cancer, according to draft revised guidance from the National Institute for Health and Care Excellence (NICE).

The recommendation, which is now out for consultation, is based on the results of a multi-country randomised trial that showed taking daily aspirin for more than two years reduced the risk of colorectal cancer in this group of patients.

Paul Chrisp, director of the centre for guidelines at NICE, said: “While there are risks associated with long-term aspirin use, the committee agreed that the benefits are likely to outweigh any potential harms.

“It is important that clinicians and patients discuss the potential harms and benefits of long-term aspirin use so that an informed decision can be made.”

It is already common practice for aspirin to be used as cancer prevention measure in the treatment of people who have Lynch Syndrome, the draft guidance says, but NICE confirmed that this is the first time that it has been recommended for the condition in its official guidance.

NICE also said it is the first time that it has recommended aspirin in the treatment of cancer prevention.

The draft guidance does not recommend a specific daily aspirin dose because NICE said the potential increased bleeding risk from taking daily aspirin was unclear, but it said a commonly used dose in current practice was either 150mg or 300mg.

In its evidence review, NICE said that currently the main strategy to prevent colorectal cancer in people who have Lynch Syndrome is regular screening with colonoscopy and polypectomy, while aspirin has been suggested as an additional option.

When considering the benefits and harms of recommending daily aspirin to help prevent colorectal cancer in people who have Lynch Syndrome, NICE found evidence to suggest that on average 30 people who have the genetic condition would have to take aspirin for two or more years instead of placebo to prevent one additional case of colorectal cancer within the first five years after treatment.

NICE found that there was no clinically important effect among people who had taken aspirin for less than two years.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206889

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