Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
Prev Med. 2022 Jan;154:106872. doi: 10.1016/j.ypmed.2021.106872. Epub 2021 Nov 9.
We undertook a systematic review to synthesise the data on attitudes and behaviour towards the use of aspirin for cancer prevention, and healthcare providers' attitudes towards implementing aspirin in practice. Searches were carried out across 12 databases (e.g. MEDLINE, EMBASE). We used the Mixed Methods Appraisal Tool to evaluate study quality, and conducted a narrative synthesis of the data. The review was pre-registered (PROSPERO: CRD42018093453). Thirty-eight studies were identified. Uptake and adherence data were all from trials. Trials recruited healthy participants, those at higher risk of cancer, and those with cancer. Four studies reported moderate to high (40.9-77.7%) uptake to an aspirin trial among people who were eligible. Most trials (18/22) reported high day-to-day adherence (≥80%). Three trials observed no association between gender and adherence. One trial found no association between adherence and colorectal cancer risk. Three studies reported moderate to high (43.6-76.0%) hypothetical willingness to use aspirin. Two studies found that a high proportion of healthcare providers (72.0-76.0%) perceived aspirin to be a suitable cancer prevention option. No qualitative studies were identified. The likelihood that eligible users of aspirin would participate in a trial evaluating the use of aspirin for preventive therapy was moderate to high. Among participants in a trial, day-to-day adherence was high. Further research is needed to identify uptake and adherence rates in routine care, the factors affecting aspirin use, and the barriers to implementing aspirin into clinical care.
我们进行了一项系统评价，综合了关于使用阿司匹林预防癌症的态度和行为的数据，以及医疗保健提供者对在实践中实施阿司匹林的态度。我们在 12 个数据库（如 MEDLINE、EMBASE）中进行了搜索。我们使用混合方法评估工具来评估研究质量，并对数据进行了叙述性综合。该综述已预先注册（PROSPERO：CRD42018093453）。确定了 38 项研究。采用和依从性数据均来自试验。试验招募了健康参与者、癌症风险较高者和癌症患者。四项研究报告了在符合条件的人群中，对阿司匹林试验的采用率为中等至较高（40.9-77.7%）。大多数试验（18/22）报告了较高的日常依从性（≥80%）。三项试验发现性别与依从性之间没有关联。一项试验发现，阿司匹林的依从性与结直肠癌风险之间没有关联。三项研究报告了中等至较高（43.6-76.0%）的假设性使用阿司匹林的意愿。两项研究发现，相当一部分医疗保健提供者（72.0-76.0%）认为阿司匹林是一种合适的癌症预防选择。未确定定性研究。有资格使用阿司匹林的用户参与评估阿司匹林用于预防治疗的试验的可能性为中等至较高。在试验参与者中，日常依从性较高。需要进一步研究以确定在常规护理中的采用率和依从率、影响阿司匹林使用的因素以及将阿司匹林纳入临床护理的障碍。
