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More Evidence Daily Aspirin Related to Lower Cancer Mortality

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A new observational study, appearing early online in the Journal of the National Cancer Institute, provides additional support for a potential benefit of daily aspirin use for cancer mortality, but the authors say the size of the benefit is undetermined.

The recent analysis, combining results from existing randomized trials of daily aspirin for prevention of vascular events, found an estimated 37% decrease in cancer mortality among patients using aspirin for 5 years or more. However, the amount of daily aspirin use required for lowering cancer mortality is still unknown, as the size of this recent analysis was limited. Moreover, 2 very large randomized trials of aspirin taken every other day found no effect on overall cancer mortality.

For the current study, American Cancer Society researchers led by Eric J. Jacobs, PhD, reviewed information from 100,139 mostly elderly participants who reported aspirin use on questionnaires. These patients did not have cancer at the onset of the study, and they were followed for up to 11 years. Among participants who reported taking aspirin daily for at least 5 years (and sometimes shorter-term daily use), researchers found an estimated 16% lower overall risk of cancer mortality. The lower overall cancer mortality was impacted by about 40% lower mortality from cancers of the gastrointestinal tract and about 12% lower mortality from cancers outside the gastrointestinal tract.

Compared with the 37% reduction reported in the recent pooled analysis of randomized trials, the reduction in cancer mortality observed in the current study is considerably smaller. The authors note that the study was observational, not randomized. Therefore, the potential effects on cancer mortality could have been underestimated or overestimated if participants who took aspirin daily had different underlying risk factors for fatal cancer than those who did not take aspirin. However, the large size of the study is important in determining the amount of daily aspirin use that might lower cancer mortality.

“Expert committees that develop clinical guidelines will consider the totality of evidence about aspirin’s risks and benefits when guidelines for aspirin use are next updated,” said Jacobs. “Although recent evidence about aspirin use and cancer is encouraging, it is still premature to recommend people start taking aspirin specifically to prevent cancer.”

Source: ACS.