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Research Article: Acceptability of aspirin for cancer preventive therapy: a survey and qualitative study exploring the views of the UK general population

Date Published: 2023-12-18

Abstract:
Objectives Aspirin could be offered for colorectal cancer prevention for the UK general population. To ensure the views of the general population are considered in future guidance, we explored public perceptions of aspirin for preventive therapy. Design We conducted an online survey to investigate aspirin use, and awareness of aspirin for cancer prevention among the UK general population. We conducted semistructured interviews with a subsample of survey respondents to explore participants’ acceptability towards aspirin for cancer preventive therapy. We analysed the interview data using reflexive thematic analysis and mapped the themes onto the Theoretical Domains Framework, and the Necessity and Concerns Framework. Setting Online survey and remote interviews. Participants We recruited 400 UK respondents aged 50–70 years through a market research company to the survey. We purposefully sampled, recruited and interviewed 20 survey respondents. Results In the survey, 19.0% (76/400) of respondents were aware that aspirin can be used to prevent cancer. Among those who had previously taken aspirin, 1.9% (4/216) had taken it for cancer prevention. The interviews generated three themes: (1) perceived necessity of aspirin; (2) concerns about side effects; and (3) preferred information sources. Participants with a personal or family history of cancer were more likely to perceive aspirin as necessary for cancer prevention. Concerns about taking aspirin at higher doses and its side effects, such as gastrointestinal bleeding, were common. Many described wanting guidance and advice on aspirin to be communicated from sources perceived as trustworthy, such as healthcare professionals. Conclusions Among the general population, those with a personal or family history of cancer may be more receptive towards taking aspirin for preventive therapy. Future policies and campaigns recommending aspirin may be of particular interest to these groups. Multiple considerations about the benefits and risks of aspirin highlight the need to support informed decisions on the medication.

Introduction:
Colorectal cancer is one of the most common cancers worldwide, with an estimated two million cases and nearly one million deaths from the disease globally in 2020. 1 There is increasing interest in the pharmacological prevention of cancer, 2 including aspirin to prevent colorectal cancer. 3 A pooled analysis of 423?495 people from 2 cohort studies found that daily aspirin use was associated with a 15% reduced risk of colorectal cancer (HR: 0.85, 95% CI=0.80 to 0.89). 4 Furthermore, a meta-analysis of four…

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