Effect of aspirin on melanoma incidence in older persons: extended follow-up of a large randomised double-blind placebo-controlled trial
Mené auprès de 19 114 participants âgés (âge médian : 74 ans ; durée médiane de suivi : 6,3 ans), cet essai international évalue l'effet d'une consommation quotidienne d'une faible quantité d'aspirine (100 mg) sur l'incidence des mélanomes cutanés
The effects of aspirin on melanoma are unclear, with studies reporting conflicting results. Data from 2 periods of the ASPirin in Reducing Events in the Elderly (ASPREE) study; the randomised placebo-controlled trial period examining daily 100mg aspirin in older adults with a median follow-up of 4.7 years, and the 2nd period, an additional 2 years of observational follow up, were utilised in this secondary analysis to examine whether aspirin exposure is associated with a reduced cutaneous melanoma incidence. All melanoma cases were adjudicated and Cox proportional hazards models were used to compare incidence between randomised treatment groups. ASPREE recruited 19,114 participants with a median age of 74 years. During the trial period, 170 individuals (76 aspirin, 94 placebo) developed an invasive melanoma, and no significant effect of aspirin was observed on incident melanoma (HR 0.81, 95%CI 0.60-1.10). Including the additional 2 years of observational follow-up (median follow-up of 6.3 years), 268 individuals (119 aspirin, 149 placebo) developed an invasive melanoma, and similar results were observed (HR=0.81, 95%CI 0.63-1.03). A reduced number of events was observed with aspirin amongst females in a subgroup analysis (HR0.65, 95%CI 0.44-0.92), however, the interaction effect with males (HR=0.92, 95%CI 0.68-1.25) was non-significant (p=0.17). Our findings from this randomised trial do not provide strong support that aspirin is associated with a reduced risk of invasive melanoma in older individuals. Additional studies are required to further explore this relationship.