More Support for Regular Use of Low-Dose Aspirin

TON - September 2017, Vol 10, No 5 - Conference Correspondent
Phoebe Starr

Washington, DC—Long-term, regular use of aspirin was associated with reduced risk for death from any cause, as well as death from cancer, in a very large observational study reported at the 2017 Annual Meeting of the American Association for Cancer Research.

Mortality from any cause was reduced by 7% for women and 11% for men who used aspirin regularly versus individuals who did not use aspirin. Cancer-related mortality was 7% lower for women and 15% lower for men who were regular aspirin users versus nonusers.

In this study of >130,000 health professionals, these apparently modest reductions have a large effect size, “comparable to the increase in the risk of cancer death associated with obesity,” stated lead investigator Yin Cao, ScD, Instructor in Medicine, Massachusetts General Hospital, Boston.

“This study adds to the evidence that aspirin not only reduces the risk of developing cancer, but may also play a strong role in reducing death from cancer,” she said.

The US Preventive Services Task Force now recommends low-dose aspirin use for ≥10 years in adults aged 50 to 69 years for the prevention of cardiovascular disease and colorectal cancer. In the present study, standard aspirin tablet doses of 0.5 to 7 per week were found to be beneficial. The minimum duration of regular use associated with reduced cancer-related mortality was 6 years.

The study included 86,206 women enrolled in the Nurses’ Health Study from 1980 to 2012, and 43,977 men enrolled in the Health Professionals Follow-Up Study from 1986 to 2012. Aspirin use was assessed at baseline and every 2 years subsequently.

With a median follow-up of 32 years, 8271 women and 4591 men died from cancer. Regular aspirin use was associated with a 30% lower risk for death caused by colorectal cancer for both sexes, 11% lower risk for death from breast cancer in women, 23% lower risk for death from prostate cancer in men, and 14% lower risk from lung cancer in men.

The regular use of aspirin carries the risk for gastrointestinal bleeding and stroke, but these risks are thought to be far outweighed by the benefits for cardiovascular disease and colorectal cancer.

According to Dr Cao, these findings suggest that the benefits of aspirin in cardiovascular disease and colorectal cancer may extend to other common cancers and causes of death. She noted that the US Preventive Services Task Force’s recommendations for aspirin are based on decision trees related to the risks and benefits in cardiovascular disease and colorectal cancer.

“Further studies are needed to capture additional benefits of aspirin use, which should be balanced against risks of adverse events,” she said.

The study’s main limitation is that it is an observational study, not a randomized controlled trial.

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Last modified: September 18, 2017