Aspirin was once celebrated for preventing heart attacks and potentially reducing cancer risk, making it a staple of preventive medicine. But a wave of new evidence — including the ASPREE trial and its 2026 follow-up — is challenging that consensus. In older adults without prior cardiovascular disease, low-dose aspirin not only failed to reduce all-cause mortality but was associated with increased cancer mortality. A 2026 Cochrane Library review further complicated the picture, while a 2025 Nature study offered a possible mechanism by which aspirin might still prevent cancer metastasis via platelet pathways. The current guidance has shifted: aspirin is no longer broadly recommended for primary prevention, though it may still hold value for specific high-risk groups like Lynch syndrome patients.
