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Cancer history and risk factors in healthy older people enrolling in the ASPREE clinical trial


Orchard, SG and Lockery, JE and Gibbs, P and Polekhina, G and Wolfe, R and Zalcberg, J and Haydon, A and McNeil, JJ and Nelson, MR and Reid, CM and Kirpach, B and Murray, AM and Woods, RL, on behalf of the ASPREE Investigator Group, Cancer history and risk factors in healthy older people enrolling in the ASPREE clinical trial, Contemporary Clinical Trials, 96 Article 106095. ISSN 1551-7144 (2020) [Refereed Article]

Copyright Statement

2020 Elsevier Inc. All rights reserved.

DOI: doi:10.1016/j.cct.2020.106095


Background: Cancer is a leading cause of death globally. Given the elevated risk of cancer with age and an ageing population, it is important to understand the changing burden of cancer in older populations. The ASPirin in Reducing Events in the Elderly (ASPREE) study randomised healthy older individuals to 100 mg aspirin or placebo, with clinical outcomes and disability-free survival endpoints. Detailed baseline data provides a rare opportunity to explore cancer burden in a uniquely healthy older population.

Methods: At study enrolment (2010-2014), self-reported personal cancer history, cancer type and cancer risk factor data were sought from 19,114 participants (Australia, n = 16,703; U.S., n = 2411). Eligible participants were healthy, free of major diseases and expected to survive 5 years.

Results: Nearly 20% of enrolling ASPREE participants reported a prior cancer diagnosis; 18% of women and 22% of men, with women diagnosed younger (16% vs 6% of diagnoses <50 years). Cancer prevalence increased with age. Prevalence of prostate and breast cancer history were higher in U.S. participants; melanoma and colorectal cancer were higher in Australian participants. Cancer history prevalence was not associated with contemporary common risk factors nor previous aspirin use, but was associated with poor health ratings in men. Blood and breast cancer history were more common with past aspirin use.

Conclusions: Personal cancer history in healthy older ASPREE participants was as expected for the most common cancer types in the respective populations, but was not necessarily aligned with known risk factors. We attribute this to survivor bias, likely driven by entry criteria.

Item Details

Item Type:Refereed Article
Keywords:aspirin, cancer epidemiology, cancer prevalence, cancer risk factors, selection criteria, survivor bias
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Epidemiology not elsewhere classified
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:140572
Year Published:2020
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-08-27
Last Modified:2020-09-04

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