If an ASPREE participant has a cancer biopsied or surgically removed through the course of their normal treatment, we will seek permission to collect a sample of the tumour tissue from the pathology service for inclusion in the ACES sub-study.There are some studies that indicate aspirin may reduce the incidence and spread of some cancers, however this has not been fully researched in older people. Before aspirin can be recommended to help prevent cancer, it needs to be proven to be safe and effective.
In 2013, the National Cancer Institute, a branch of the National Institutes of Health in the USA, provided additional funding to better understand the relationship between cancer and aspirin in healthy older people.
ACES, the ASPREE Cancer Endpoints Study, will further investigate the effect of aspirin on the development and spread (metastasis) of different types of cancer.
All ASPREE participants are invited to be in the ACES study, regardless of where they live, in the USA or Australia. Participation is completely voluntary and will not affect participation in the principal ASPREE study.
What does participation involve?
The ACES sub-study has 3 components:
- Collecting cancer-related information During a study visit, ASPREE research staff will ask a series of questions about lifestyle factors such as smoking and drinking history, cancer screening, tests, cancer diagnoses (old and new) and family history of cancer.
- Storing a genetic sample of blood or saliva We may ask ASPREE participants, who have not already provided a blood sample to the Healthy Ageing Biobank, for a one-time saliva (spit) sample, which can be donated during a visit or afterwards from home.
- Storing a tumour sample If an ASPREE participant has a cancer biopsied or surgically removed as part of their doctor’s care, we will seek permission to collect a small sample of the tumour tissue for storage in our biorepository. Consent for our staff to contact the pathology service is only required once and can be given at a study visit.
The biorepository of blood, saliva and cancer tissue from ASPREE participants will facilitate genetic investigation into the effect of aspirin on cancer. Research using these samples may help predict the incidence of specific cancers, their spread (metastasis) and the impact of a therapy on cancer-free survival.
Frequently asked questions about aspirin, cancer and the ACES sub-study
How does aspirin affect cancer?
It is not understood how aspirin may affect cancer. Possible mechanisms include:
- aspirin may reduce inflammation which may be a precursor to some cancer development
- aspirin may help the body expel the ‘rogue’ cancer cells which otherwise have the ability to multiply unchecked
- aspirin may limit the development of blood vessels which are needed to support tumour growth
- aspirin may impede the spread of cancer cells through an effect on platelets.
What does the ACES study involve?
- You will be provided with information about the ACES sub-study and asked for your consent to be involved.
- During a study visit, ASPREE staff will ask you a series of questions about lifestyle factors such as smoking and drinking history, cancer screenings, cancer diagnosis (old or new) and family history of cancer. If you haven’t already provided a sample of blood for the Healthy Ageing Biobank, you will be asked to provide a one-off saliva sample during your study visit or later at home.
- No further action is required. However, if at some point during your time in the trial, you do have a cancer biopsied or surgically removed, we will seek permission to collect a sample of the tumour from the pathology service. ASPREE staff will handle and coordinate this request for tissue. This sample will be stored in our biorespository for further research.
In Australia, saliva and tumour samples are de-identified and stored with blood and urine samples in the ASPREE Healthy Ageing Biobank. The Healthy Ageing Biobank is a biorepository- a ‘library’ or ‘bank’ of biological specimens that form an invaluable resource for future research into diseases that affect older people.
How does saliva and blood help to study cancer?
• Future research on the samples may reveal relationships between a particular type of cancer and the presence of a protein in the blood or perhaps anomalies in the genetic pattern. For instance, in other studies the ‘Philadelphia’ chromosome has been shown to be associated with chronic myeloid leukaemia (CML). Individuals identified as being at greater risk of CML can then be closely monitored by their health care provider. This allows early disease detection and leading to better disease management and patient outcomes.
• Research on biospecimens may provide the bridge between physical health and what is happening at a genetic or cellular level to better predict who is at an increased risk of a type of cancer. It may also help identify the best therapy to prevent or treat the disease.
What will happen to my saliva and tumour sample?
Where is the ACES study being undertaken?
How are tumour samples collected?
With your consent, ASPREE ACES staff will contact the pathology provider, requesting a small sample of the cancer for long-term storage in the biorepository,
Your consent for ASPREE to contact the pathology service is only required once and can be given at a study visit.
How will ASPREE know when I’ve had a tumour removed?
Are there any types of cancer tumours that aren’t included in the study?
- Monash University
- Berman Center for Outcomes and Clinical Research (Minnesota) plus 21 centres in the USA
- Menzies Research Institute (TAS)
- The University of Melbourne
- Australian National University
- The University of Adelaide
- GP Co-investigators
- National Cancer Institute (NCI), USA
- Monash University
- Commonwealth Scientific and Industrial Research Organisation (CSIRO)