Dietary or pharmaceutical salicylates might reduce the
risk of cancer—there is evidence that aspirin aff ects
mechanisms relevant to carcinogenesis—but the value of
aspirin in cancer prophylaxis is limited by the constraints
on randomised placebo-controlled clinical trials. More
evidence from every possible source is therefore needed
before the role of aspirin in clinical practice can be more
clearly defi ned.
Aspirin is prone to undesirable side-eff ects, in particular
bleeding, and development of a safer form of aspirin, or
a drug combination, should be urgently undertaken to
improve the risk-benefi t balance. In this context, the
relevance of infection with H pylori should be further
investi gated. The risk–benefi t balance of aspirin for
cancer prophylaxis should also be assessed in conjunction
with its well established benefi ts in vascular disease.