Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. preventive services task force recommendation statement

U.S. Preventive Services Task Force

Research output: Contribution to journalReview article

372 Citations (Scopus)

Abstract

Description: Update of the 2009 USPSTF recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal antiinflammatory drug use to prevent colorectal cancer (CRC). Methods: The USPSTF reviewed 5 additional studies of aspirin for the primary prevention of CVD and several additional analyses of CRC follow-up data. The USPSTF also relied on commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms. The USPSTF then used a microsimulation model to systematically estimate the balance of benefits and harms. Population: This recommendation applies to adults aged 40 years or older without known CVD and without increased bleeding risk. Recommendations: The USPSTF recommends initiating lowdose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, 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. (B recommendation) The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take lowdose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. (C recommendation) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement).

Original languageEnglish (US)
Pages (from-to)836-845
Number of pages10
JournalAnnals of Internal Medicine
Volume164
Issue number12
DOIs
StatePublished - Jun 21 2016

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Advisory Committees
Primary Prevention
Aspirin
Colorectal Neoplasms
Cardiovascular Diseases
Hemorrhage
Life Expectancy
Mortality
Young Adult
Anti-Inflammatory Agents
Incidence

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer : U.S. preventive services task force recommendation statement. / U.S. Preventive Services Task Force.

In: Annals of Internal Medicine, Vol. 164, No. 12, 21.06.2016, p. 836-845.

Research output: Contribution to journalReview article

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title = "Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. preventive services task force recommendation statement",
abstract = "Description: Update of the 2009 USPSTF recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal antiinflammatory drug use to prevent colorectal cancer (CRC). Methods: The USPSTF reviewed 5 additional studies of aspirin for the primary prevention of CVD and several additional analyses of CRC follow-up data. The USPSTF also relied on commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms. The USPSTF then used a microsimulation model to systematically estimate the balance of benefits and harms. Population: This recommendation applies to adults aged 40 years or older without known CVD and without increased bleeding risk. Recommendations: The USPSTF recommends initiating lowdose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10{\%} or greater 10-year CVD risk, 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. (B recommendation) The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10{\%} or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take lowdose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. (C recommendation) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement).",
author = "{U.S. Preventive Services Task Force} and Kirsten Bibbins-Domingo and Grossman, {David C.} and Curry, {Susan J.} and Davidson, {Karina W.} and Epling, {John W.} and Garcia, {Francisco A} and Matthew Gillman and Harper, {Diane M.} and Kemper, {Alex R.} and Krist, {Alex H.} and Kurth, {Ann E.} and Landefeld, {C. Seth} and Mangione, {Carol M.} and Phillips, {William R.} and Phipps, {Maureen G.} and Pignone, {Michael P.} and Siu, {Albert L.} and Owens, {Douglas K.} and LeFevre, {Michael L.}",
year = "2016",
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T1 - Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer

T2 - U.S. preventive services task force recommendation statement

AU - U.S. Preventive Services Task Force

AU - Bibbins-Domingo, Kirsten

AU - Grossman, David C.

AU - Curry, Susan J.

AU - Davidson, Karina W.

AU - Epling, John W.

AU - Garcia, Francisco A

AU - Gillman, Matthew

AU - Harper, Diane M.

AU - Kemper, Alex R.

AU - Krist, Alex H.

AU - Kurth, Ann E.

AU - Landefeld, C. Seth

AU - Mangione, Carol M.

AU - Phillips, William R.

AU - Phipps, Maureen G.

AU - Pignone, Michael P.

AU - Siu, Albert L.

AU - Owens, Douglas K.

AU - LeFevre, Michael L.

PY - 2016/6/21

Y1 - 2016/6/21

N2 - Description: Update of the 2009 USPSTF recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal antiinflammatory drug use to prevent colorectal cancer (CRC). Methods: The USPSTF reviewed 5 additional studies of aspirin for the primary prevention of CVD and several additional analyses of CRC follow-up data. The USPSTF also relied on commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms. The USPSTF then used a microsimulation model to systematically estimate the balance of benefits and harms. Population: This recommendation applies to adults aged 40 years or older without known CVD and without increased bleeding risk. Recommendations: The USPSTF recommends initiating lowdose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, 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. (B recommendation) The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take lowdose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. (C recommendation) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement).

AB - Description: Update of the 2009 USPSTF recommendation on aspirin use to prevent cardiovascular disease (CVD) events and the 2007 recommendation on aspirin and nonsteroidal antiinflammatory drug use to prevent colorectal cancer (CRC). Methods: The USPSTF reviewed 5 additional studies of aspirin for the primary prevention of CVD and several additional analyses of CRC follow-up data. The USPSTF also relied on commissioned systematic reviews of all-cause mortality and total cancer incidence and mortality and a comprehensive review of harms. The USPSTF then used a microsimulation model to systematically estimate the balance of benefits and harms. Population: This recommendation applies to adults aged 40 years or older without known CVD and without increased bleeding risk. Recommendations: The USPSTF recommends initiating lowdose aspirin use for the primary prevention of CVD and CRC in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, 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. (B recommendation) The decision to initiate low-dose aspirin use for the primary prevention of CVD and CRC in adults aged 60 to 69 years who have a 10% or greater 10-year CVD risk should be an individual one. Persons who are not at increased risk for bleeding, have a life expectancy of at least 10 years, and are willing to take lowdose aspirin daily for at least 10 years are more likely to benefit. Persons who place a higher value on the potential benefits than the potential harms may choose to initiate low-dose aspirin. (C recommendation) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults younger than 50 years. (I statement) The current evidence is insufficient to assess the balance of benefits and harms of initiating aspirin use for the primary prevention of CVD and CRC in adults aged 70 years or older. (I statement).

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