Another Aspirin Benefit?

A single baby aspirin a day may reduce your risk of many types of cancer, a clever study published online in the Lancet concludes.  Rick and I both agree in this week's podcast that the study is clever because it took data from studies where aspirin was being examined for its ability to reduce cardiovascular events and analyzed the risk of death from cancer in the same study participants.  When these trials were considered together almost 26,000 people were studied over several years duration, so the conclusions can be considered robust.

Turns out that daily aspirin use reduced the risk of death from cancer of any type by about 20% while the trials studied were going on, but by about 30-40% after five years of treatment with aspirin.  This reduction was not related to any specific dose of aspirin greater than 75 mg/day, and benefits were seen to increase as people aged and were treated for longer periods of time. 

Cancers known as adenocarcinomas were specifically reduced with aspirin use.  These are cancers arising from epithelial cells originating in glandular tissue. Which common cancers are adenocarcinomas?  These would include the vast majority of colorectal, lung, prostate, breast, pancreas and stomach cancers.

There's quite a bit of good news in this study.  It's great that the benefits of taking aspirin were seen with such a modest dose. That's because at higher doses aspirin is known to cause stomach ulcers and bleeding, and sometimes with the chronic ringing in the ears known as tinnitus.  It's also good news that the benefits accrue with duration of treatment and age, since cancer is largely a disease afflicting more of us as we grow older.  For the majority, a baby aspirin a day is unlikely to cause problems but appears to offer substantial benefits.

How is it that aspirin appears to provide such a benefit? Aspirin is just one of that big and growing class of medications known as nonsteroidal anti-inflammatory drugs, abbreviated NSAIDs.  These drugs exert an inhibitory action on an enzyme known to be involved in promoting inflammation, and perhaps others as well.  Inflammation is increasing recognized as one important player in a range of chronic diseases, including cancer.  It's likely aspirin has other important effects as well.

As with any other new medicine, talk with your doctor before you dose yourself with aspirin and make sure he or she knows you are taking it when you go in for check-ups.

Other topics in this week's podcast include sex in older men in Annals of Internal Medicine, whether aspirin compromises one screening test for colon cancer in JAMA, and new guidelines for assessing food allergies in the Journal of Allergy and Clinical Immunology.  Until next week, y'all live well.

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