The short answer
In 2022 the USPSTF removed colorectal cancer prevention from its aspirin recommendation, concluding the evidence is unclear. It now advises against starting aspirin for prevention at age 60 or older.
In April 2022 the USPSTF removed colorectal cancer from its aspirin recommendation, concluding that "the evidence is unclear whether aspirin use reduces the risk of colorectal cancer incidence or mortality."
For adults aged 60 and older, the USPSTF now recommends against starting low-dose aspirin for primary prevention (grade D). For adults 40 to 59 with at least 10% ten-year cardiovascular risk, it is an individual decision (grade C).
The ASPREE trial randomized 19,114 mostly older adults to 100 mg aspirin daily or placebo; follow-up published in 2026 found no reduction in cancer incidence and a 15% higher risk of cancer death among those who developed cancer (HR 1.15, 95% CI 1.03 to 1.29).
Aspirin raises the risk of gastrointestinal bleeding, bleeding in the brain and hemorrhagic stroke, and that risk climbs with age.
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The full explanation.
The claim
A daily low-dose aspirin prevents colorectal cancer, so healthy adults should take one.
What changed in 2022
For years the US Preventive Services Task Force recommended low-dose aspirin partly because it appeared to prevent colorectal cancer. In April 2022 the Task Force withdrew that rationale. Its current statement is about heart disease only, and colorectal cancer was removed from the recommendation. The Task Force concluded that the evidence is unclear on whether aspirin use reduces the risk of colorectal cancer incidence or mortality.
The current grades matter. For adults aged 40 to 59 whose ten-year cardiovascular risk is 10% or higher, starting low-dose aspirin is an individual decision to make with a clinician. For adults aged 60 and older, the Task Force recommends against starting aspirin for primary prevention, because the bleeding harms outweigh the benefit at that age.
If a headline tells you healthy older adults should take aspirin to prevent colon cancer, it is out of date.
What the evidence shows
Older observational studies and long-term follow-up of heart trials suggested that several years of daily aspirin lowered colorectal cancer rates, and NCI's patient summary still reflects that earlier literature. Newer randomized data pointed the other way.
ASPREE randomized 19,114 adults, most of them aged 70 and older, to 100 mg of aspirin daily or placebo. Follow-up published in 2026, with a median of 8.6 years, found no reduction in cancer incidence at any stage. Among participants who went on to develop cancer, death from cancer was 15% higher in the aspirin group. The investigators' plain-language conclusion was that starting a program of low-dose aspirin to prevent cancer is not recommended in older adults.
Aspirin's harms are not theoretical. It increases the risk of bleeding in the stomach and intestines, bleeding in the brain, and hemorrhagic stroke, and that risk rises steadily with age. That is precisely why the balance tips at 60.
Where aspirin still has a role
Two situations are different and should not be lumped in with the general advice.
The first is Lynch syndrome, an inherited condition that sharply raises colorectal cancer risk. In the CAPP2 randomized trial, long-term daily aspirin reduced colorectal cancers in this group, and specialist guidelines discuss aspirin for these patients as a prescribed, individualized decision.
The second is people who have already had a heart attack, stroke or stent. That is secondary prevention, a different question with a different answer, and the 2022 statement does not apply to it.
What this does not mean
It does not mean aspirin is dangerous for everyone, and it is not a signal for anyone to stop taking it on their own. Stopping aspirin abruptly after a cardiovascular event can be harmful, which is why that conversation belongs with the clinician who prescribed it.
It also does not mean colorectal cancer cannot be prevented. It can. Screening on schedule, whether colonoscopy or a stool-based test, starting at age 45 for people at average risk, actually finds and removes precancerous polyps. That is the intervention with the strongest evidence behind it, and it is available to you now.
The bottom line
For most healthy adults, daily aspirin is no longer recommended as a way to prevent colorectal cancer. The evidence that it helps is unclear, the bleeding risk is real and grows with age, and the official guidance changed in 2022. Whether aspirin belongs in your life is a decision to reach with your clinician, weighing your heart risk, your bleeding risk and any inherited cancer syndrome in your family.
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Words to know
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Common questions
Does the USPSTF still recommend aspirin to prevent colorectal cancer?
No. Colorectal cancer prevention was removed from the recommendation in April 2022. The current statement covers cardiovascular disease only, and the Task Force concluded the evidence is unclear on whether aspirin reduces colorectal cancer incidence or mortality.
Why did the recommendation change?
Newer randomized evidence and longer follow-up did not support the earlier benefit. In particular, the ASPREE trial in older adults found no reduction in cancer incidence, and higher cancer mortality among participants who developed cancer. At the same time the bleeding harms of aspirin became clearer, especially after age 60.
I have been taking a daily aspirin for years. Should I stop?
That is a question for your clinician, not something to decide from an article. Stopping aspirin can be harmful for people taking it after a heart attack, stroke or stent. Bring the reason you started, your bleeding history and your heart risk to your next visit and decide together.
Is there anyone for whom aspirin does help prevent colorectal cancer?
Yes. People with Lynch syndrome, an inherited condition that sharply raises colorectal cancer risk, had fewer colorectal cancers on long-term daily aspirin in the CAPP2 randomized trial, and specialist guidelines discuss aspirin for this group. That is a prescribed, individualized decision with a genetics or gastroenterology team.
What actually lowers colorectal cancer risk?
Screening, most of all. Colonoscopy and stool-based tests, starting at age 45 for people at average risk, find and remove precancerous polyps before they become cancer. Not smoking, limiting alcohol, staying active and eating more fiber all help too.
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Written by: Cancer Explained Editorial TeamSources last checked: 2026-07-30Last updated: 2026-07-30Next planned review: 2028-07-29
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Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
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Human medical review: not completed. Cancer Explained is not clinician-reviewed, and that is a deliberate design choice rather than a gap we are waiting to close. We restate published federal guidance and cite it; the authority belongs to the source, not to us. That is why every page names where its claims come from — so you can verify us instead of trusting us. Use it to understand your situation and to ask better questions of the people treating you.
How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source verified — This page was created with AI assistance and checked against the sources listed on it. Source checking is not a medical review.
Human medical review: not completed. Cancer Explained is not clinician-reviewed, and that is a deliberate design choice rather than a gap we are waiting to close. We restate published federal guidance and cite it; the authority belongs to the source, not to us. That is why every page names where its claims come from — so you can verify us instead of trusting us. Use it to understand your situation and to ask better questions of the people treating you.
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