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Development of a brief decision aid to present the benefits and risks of Aspirin as a preventive strategy for bowel cancer to members of the public who are eligible for screening

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Dr Stephanie Smits & Dr Sunil Dolwani, Cardiff University
Start date: May 2018
Duration: 15 months 
Funded amount: £28,782


Bowel cancer screening leads to a reduction in bowel cancer deaths of around 16%. Low-dose aspirin is associated with reduction in bowel cancer deaths of about 20%. Combining the two methods – bowel screening and aspirin – may bring additional benefit compared with either alone. In future, low dose aspirin could be offered alongside bowel screening as a combined approach to preventing bowel cancer.

StephanieBenefits of taking low-dose aspirin include less chance of developing bowel cancer and heart disease. However, risks may include bleeding from the stomach and more rarely, bleeding into the brain. If aspirin were offered as a preventive strategy as part of the bowel screening programme, risks and benefits would need to be presented in a way that enables people to make an informed choice about taking aspirin.

Over three phases of work, we will examine the acceptability and feasibility of a brief decision aid to support screening eligible members of the public choosing whether or not to take aspirin alongside bowel screening. We will summarise the clinical evidence on aspirin and collect data on people’s views on different formats for presenting the risks and benefits. We will use these findings to develop a brief decision aid about the risks and benefits of preventive aspirin use. We will then test the draft decision aid with a sample of potential users. This development work is necessary for future evaluation of a combined risk-reducing strategy for bowel cancer.