It’s always a pleasure to see a mainstream media outlet providing the big picture on medical therapies. So I was fascinated by a recent opinion piece in the New York Times which called for the increased use of aspirin.
In the article, cancer-researcher Dr. David Agus makes a clear case of the health benefits of aspirin. For years, the evidence has clearly established that aspirin reduced the risk of cardiovascular disease. In fact, he points out, the U.S. Preventative Services Task Force – an independent panel of health care experts – recommended aspirin for people up to 80 years old to prevent heart disease.
Now there is a growing body of solid evidence that aspirin also helps reduce the risk of cancer. Several major systematic reviews found that people who take an aspirin a day over the period of several years reduce their risk of developing cancer.
One major systematic review published by British researchers pulled together data on more than 77,000 patients from 51 separate clinical trials. It found some striking results: people who took aspirin daily were 15 percent less likely to die from cancer compared with those who didn’t take aspirin. They also had a 38 percent reduction in the risk of colorectal and gastrointestinal cancer. And for aspirin-takers who did get cancer, it was 38 percent less likely to spread to other parts of their bodies.
Other reviews have found that aspirin use not only reduces the risk of colorectal and gastrointestinal cancer but also decreases distant metastasis, the spreading of cancer to new regions of the body.
The take-home message: While people have been using aspirin for thousands of years, it was likely to be providing more health benefits than were ever realized.
I wonder how the recent study showing regular aspirin use correlated with an increased risk of wet macular degeneration should factor into the tradeoffs here. http://www.webmd.com/eye-health/news/20130118/aspirin-blinding-eye-disease
Perhaps decisions on taking aspirin regularly should depend on which genetic risks an individual faces and how they value the potential consequences. I’d be interested in seeing how somebody might assess the baseline tradeoffs here if this new study is accurate.
Many of the studies on aspirin for cardio-prevention, such as the Physicians Health Study, used very low doses of aspirin, either 81 mg or 100 mg (available in Europe) rather than the 325 mg dose. This is important since the risk of bleeding due to aspirin has been found to be dose related (particularly gastrointestinal bleeding due to ulcers). The biological mechanism for aspirin’s cardiovascular prevention is thought to be due to inhibition of platelets and clot prevention, and this is biologically plausible since most heart attacks begin with clot or thrombus formation. However, the mechanisms by which aspirin prevent cancer are yet to be worked out, and this is exciting work for future.