According to Biggest Study Yet – Aspirin a day could dramatically cut cancer risk
Daily pill for middle-aged could save 130,000 lives over 20 years in Britain alone, scientists suggest
An aspirin a day could dramatically cut people’s chances of getting and dying from common cancers, according to the most detailed review yet of the cheap drug’s ability to stem disease.
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More than 130,000 deaths would be avoided over a 20-year period if Britain’s 50- to 64-year-olds took a daily aspirin for 10 years, because the beneficial effects continue even when the aspirin is stopped, the authors say.
A research team led by Professor Jack Cuzick, head of the center for cancer prevention at Queen Mary University of London, concluded that people between 50 and 65 should consider regularly taking the 75mg low-dosage tablets.
Cuzick said that taking aspirin “looks to be the most important thing we can do to reduce cancer after stopping smoking and reducing obesity, and will probably be much easier to implement”.
In a briefing to journalists, the scientist added that he had been dosing himself for the last four years, keeping the tablets beside his bed. “I take aspirin as part of a bedtime ritual every day and I can achieve that quite easily,” he said.
However, to obtain the newfound benefits of the drug, people would have to take aspirin for at least five years and probably 10, the review said.
Aspirin was originally developed as a painkiller and treatment for fever and inflammation, but more than a century after it was first synthesized from willow bark, researchers have found more medical uses for it.
It has been demonstrated to reduce the risks of heart attacks and strokes as well as the chances of some cancers. But the big question has been whether the benefits outweigh the harms, because aspirin can cause stomach bleeds, which could be potentially fatal in some people.
Concluding that the benefits outweighed the risks, Cuzick’s team, writing in the cancer journal Annals of Oncology, said that by taking low-dose aspirin every day for 10 years, bowel cancer cases could be cut by about 35% and deaths by 40%. Aspirin could reduce rates of oesophageal and stomach cancers by 30% and deaths from them by 35% to 50%.
However, taking aspirin every day for 10 years increases the risk of stomach bleeds among 60-year-olds from 2.2% to 3.6%. In about 5% of those who have a stomach bleed, it could be fatal.
Cuzick added that there was evidence that this side-effect could be more common in people who have the bacterium Helicobacter pylori in their stomach, which also causes peptic ulcers. He said people considering embarking on a regime of daily aspirin should talk to their GP and it might be possible to be tested first.
A second risk is stroke. Aspirin is already given to some people to reduce their risk of heart attacks or ischemic stroke, caused by blood clots, which it does by thinning the blood. But it is likely to worsen a haemorrhagic stroke, caused by bleeding in the brain.
The study also shows that 10 years of aspirin reduces heart attacks by 18% and deaths by 5%, but although it reduces stroke numbers by 5%, there is a 21% increase in deaths.
All the cancers in which aspirin has a beneficial effect have some lifestyle causes – from smoking in lung cancer to alcohol in oesophageal cancer and obesity in all of them. Taking aspirin, said Cuzick, “should not be seen as a reason for not improving your lifestyle”. The drug, however, would reduce the cancer risk even in people who have a healthy lifestyle, he said.
Increasing numbers of people in middle age are already being prescribed cholesterol-lowering statins to reduce their risk of heart attacks and strokes. Recently there has been an outcry over the “medicalisation” of the population and concern about side-effects – which trial data suggest are less common and less serious than those in aspirin. Cuzick said there was no evidence of any interaction between the two drugs.
“In many people, taking both of them is probably a good idea,” he said.
However, Cancer Research UK (CRUK)warned that people should speak to their GP before starting on daily aspirin. The charity said it would like to see more research on who should and should not be taking it.
“Aspirin is showing promise in preventing certain types of cancer, but it’s vital that we balance this with the complications it can cause – such as bleeding, stomach ulcers, or even strokes in some people,” said Dr Julie Sharp, head of health information at CRUK.
“Before aspirin can be recommended for cancer prevention some important questions need to be answered, including what is the best dose and how long people should take it for. And tests need to be developed to predict who is likely to have side-effects.
“Given the continued uncertainty over who should take aspirin, Cancer Research UK is funding a number of trials and research projects to make the picture clearer,” she said.