Health Column: Does aspirin reduce cancer risk?
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
Aspirin, discovered in the bark of willow trees in 1763, was first synthesized by a chemist, Felix Hoffman, working for the German company Bayer in 1897. Today aspirin is widely used for fever and pain. It is also consumed long term to help prevent heart attacks and strokes.
There is accumulating evidence suggesting that aspirin’s most important role may be in decreasing the risk of cancer. In the August 5, 2014, Annals of Oncology, Dr. Cuzick and colleagues presented the largest ever review of the benefits and harms of aspirin.
1) Although aspirin seems to have the greatest preventive effect on cancers of the G.I. tract (particularly colon), there is also evidence of a preventive effect on lymphomas and some female genital cancers.
2) The effects of aspirin on cancer are not apparent until at least three years after the start of use, but some benefits are sustained for several years after stopping aspirin.
3) There were no differences between low (75-81 mg.) and standard (325-650 mg.) doses of aspirin. Higher doses of aspirin do not appear to confer additional benefit, but increase the risk of bleeding.
4) In two trials where participants took aspirin every other day, there was no reduction in cancer deaths after 10 years of follow-up.
5) Three trials conducted in the United Kingdom have continued to collect data up to 20 years. In these studies, the 20 year risk of death from cancers remained 20 percent lower in patients taking aspirin. Benefit increased with increasing duration of aspirin treatment.
Here’s the take-home: If 1,000 people took daily aspirin (81 mg.) for 10 years starting at age 60, it would prevent 16 deaths from cancer; prevent one death from a heart attack; and cause two extra deaths from bleeding (mostly hemorrhagic strokes).
One must remain skeptically optimistic of these results as many of the studies in the analysis were not originally designed to look at aspirin’s effect on cancer. Large studies focusing on aspirin’s effect on cancer are underway. If the results of the impending studies are half as good as the existing ones, humble aspirin will become a game changer!
Note: “Aspirin” is a Bayer trade name. Acetylsalicyclic acid is the generic equivalent, works fine and is less expensive.
Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at email@example.com.
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