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The processing of the NHS registry data will allow accurate coding of the medical events experienced by the people taking part in the study, ensuring high quality information (data) are available for any analyses.

Types of analyses

The data collected from central NHS registries during the Long–Term Follow-up phase of the study, will be used to assess whether the balance of benefits versus hazards of aspirin observed within the trial, relating to major vascular events such as heart attack or stroke, continue long-term or whether additional benefits emerge during longer-term follow-up.

It had been suggested that low-dose aspirin might protect against cancer and ASCEND provides one of the first opportunities to test this hypothesis. The analyses based on the study treatment phase showed no reduction in any cancers during the (up to) 9 years of follow-up available so far. However, the main focus of the analyses will be after longer-term post-trial follow-up has been collected, when the study team will be much better position to assess whether there is any benefit.

Dementia and cognitive impairment are increasing globally with increasing lifespan. Diabetes is associated with an increased risk of developing these conditions and so the study team are investigating whether taking aspirin provides any benefit.

Diabetic retinopathy and diabetic maculopathy are among the most common causes of registerable blindness among working-age adults in the UK. The eye sub-study is assessing the impact of aspirin and omega-3 fatty acids on various eye outcomes including diabetic retinopathy, macular degeneration and cataracts by allowing linkage to diabetic screening registry information. Visual loss impacts significantly on the quality of life for those people affected, as well as generating financial costs to the NHS ophthalmology services. Therefore the preservation of vision is extremely important.