Does an Aspirin a day prevent cancer?

TORONTO — A new study suggests that regular Aspirin use may reduce the risk of cancer. But does this mean that all of us should be taking an Aspirin a day?

Here’s my take.

In a study published in JAMA Oncology, authors analyzed data from two large databases, including 135,965 people followed for as long as 32 years.

They found that those who had used Aspirin regularly had a slightly lower risk of developing any type of cancer compared to those who did not.

When they looked at which types of cancer were actually being prevented, Aspirin did not affect cancers such as breast, prostate or lung, but reduced the risk of gastrointestinal cancers and particularly colorectal cancer.

And the benefit was small – for every 100,000 people over the age of 50 who took Aspirin regularly, 33 colorectal cancers were prevented each year.

And this benefit was even smaller in people who had a screening colonoscopy – presumably because any polyps would be removed before they became cancerous.

Also, for any benefit to appear, people had to take the equivalent of at least one baby Aspirin per day for at least six years.

Previous smaller studies have also shown that regular Aspirin use reduces rates of colorectal cancer.

In fact, last year, the U.S. Preventive Services Task Force put out a draft recommendation suggesting that people aged 50 to 59 should take low-dose Aspirin and people aged 60 to 69 should consider taking low-dose Aspirin to prevent colorectal cancer, as long as they don’t have an increased risk of bleeding.

Aspirin has also been shown to be of benefit to prevent heart attacks in healthy people who are at risk (defined as approximately a 10 per cent or higher risk of having a heart attack over the next 10 years), so it is also recommended for this purpose, in the same age groups.

So there are two potential benefits for people aged 50 to 69 – preventing both heart disease and colon cancer. But Aspirin is not without risks.

It works by interfering with the function of our platelets, which are essential in forming clots.

As a result, people talking Aspirin have a slightly higher risk of having bleeds in the gastrointestinal tract and in the brain, as well as major bleeding in other areas. And there are other risks.

For example, patients of mine with asthma sometimes have Aspirin sensitivity, which means that a single dose makes their asthma dramatically worse.

So should all people aged 50 to 69 take a daily low dose Aspirin?

Like most things in medicine, there’s no one size fits all recommendation.

It’s an individual decision based on your risk of heart disease and colon cancer, considering your overall risk factor profile, including your family history, all of which has to be carefully balanced against your risk of bleeding.

So if you are in that age group, make sure you have that conversation with your doctor.