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An international scientific meeting on aspirin is needed
  1. G Morgan
  1. Department of Public Health, Iechyd Morgannwg Health Authority, 41 High Street, Swansea SA1 1LT, UK; gareth.morgan{at}morgannwg-ha.wales.nhs.uk

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    Aspirin (acetylsalicylic acid) is inexpensive and widely used to treat numerous common conditions. Perhaps its most important use now is the reduction of the risk of cardiovascular disease morbidity and mortality. As with all medicines, there are undesirable effects to its use, most notably gastrointestinal irritation and bleeding. Low dose aspirin is comparatively safe, however, and in the reduction of cardiovascular disease risk the potential benefit must be balanced against potential risk.

    Observational epidemiological studies suggest that the regular use of aspirin may lead to a reduced risk of several other diseases. This includes certain cancers, particularly those in the gastrointestinal tract, and the most persuasive evidence relates to colorectal cancer. At least seven randomised controlled trials to test the aspirin and colorectal cancer hypothesis have been set up and preliminary data from one of these trials are promising. Results from other trials are expected in the near future.

    Aspirin has the potential to make a substantial beneficial contribution to disease control programmes. Malevolent health threats require concerted and coordinated international research and development programmes. HIV/AIDS and “the war on drugs” are examples of this. No international programmes are being planned for benevolent aspirin. The profile of aspirin, with its unique potential to reduce the risk of several major diseases, therefore needs to be raised.

    An aspirin meeting would serve at least two purposes. Firstly, it would raise the profile of its beneficial health potential. Secondly, it would provide an opportunity for a critical review of the aspirin evidence base. Experts from numerous disciplines including the fields of aspirin research, cardiology, epidemiology, oncology, and public health should be invited to such a meeting. The publication of a meeting report would allow the research and development recommendations to be disseminated.

    Aspirin has a fascinating history. In 1763, Reverend Edmund Stone from Chipping Norton, Oxfordshire, United Kingdom, wrote to the President of the Royal Society to describe the treatment of ague (fever) using powdered willow tree bark, which contains salicylic acid. In 1899, Bayer patented and marketed aspirin. This was a significant landmark in the history of medicine and the next 100 years of aspirin promises to be equally fascinating. This paper issues a wide call for an international scientific meeting on aspirin to be convened at the earliest possible opportunity.

    Acknowledgments

    This article is based on a public health and epidemiology seminar titled The Public Health Potential of Aspirin given at Green College, Oxford, United Kingdom on 7 May 2002. Professor Peter Elwood is gratefully acknowledged for his enthusiastic support and encouragement.

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