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the population taking aspirin. Due to the small sample size, we could not evaluate the factors regarding
to the inappropriate use of aspirin. Only 3.9% of participants were taken aspirin regularly in this study.
Finally, this trial enrolled only Korean participants, limiting the generalizability of our findings to other
geographic regions. Concerns have been raised that this guideline is the only US-based, externally validated
equations that report risk as a combination of CVD, stroke, and CRC events. There may be limitations in
general applications of the risk functions to other ethnic populations due to the differences in diet pattern,
life style, social environment, or genetic predisposition [20,21] . These limitations should be considered during
the interpretation of our data.

In conclusion, the decision to take aspirin is still an individual one, which should be made after careful
evaluation of the trade-off between the benefits and risks, particularly the risk of major bleeding. This study
showed that aspirin would be indicated in nearly one-quarter of the adults aged 50 to 69 years who undergo a
medical check-up but only 6% were taking aspirin appropriately based on the 2016 USPSTF recommendations.
These results suggested that there may be an opportunity for decreasing the rate of CVD as well as the risk
for major bleeds through tailored education on aspirin use.

DECLARATIONS
Authors’ contributions
Conceived of the study: Baik JS
Recruitment and clinical assessment: Im JH, Han SW, Lee SY
Statistical analysis: Han SW
Drafted the initial version of the report: Im JH
Revision and editing of the report: all authors

Data source and availability
The dataset used and analysed during the current study are available from the corresponding author on
reasonable request.

Financial support and sponsorship
None.

Conflicts of interest
There are no conflicts of interest.

Patient consent
All study participants provided informed consent.

Ethics approval
The study design was approved by the appropriate ethics review board and conducted in accordance with the
Good Clinical Practice guidelines and the Declaration of Helsinki.

Copyright
© The Author(s) 2018.

REFERENCES
1. US Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: US Preventive Services Task Force
recommendation statement. Ann Intern Med 2009;150:396-404.
2. Ittaman SV, VanWormer JJ, Rezkalla SH. The role of aspirin in the prevention of cardiovascular disease. Clin Med Res 2014;12:147-54.