More Evidence That Daily Aspirin Use Decreases Cancer Mortality

Since it was first isolated from the bark of the willow tree, aspirin (also known as acetylsalicylic acid) has been used for both its analgesic and antipyretic properties. Aspirin is beneficial for many diseases, and in modern times has been used for headaches, arthritic pain, and muscle aches. Aspirin causes irreversible inactivation of an enzyme called cyclooxygenase which results in decreased prostaglandin and thromboxane production. Platelet aggregation is dependent on the proper functioning of cyclooxygenase, and thus aspirin has found a role in the treatment of vascular diseases that are influenced by platelet aggregation. In particular, aspirin can help prevent heart attacks and strokes by preventing platelets from aggregating in coronary arteries and cerebral arteries, respectively.

Researchers, lead by Dr. Eric Jacobs from the American Cancer Society, have found that daily aspirin use is associated with decreased mortality from cancer. The results of their study were published online in the Journal of the National Cancer Institute. The researchers used a prospective study of 100,139 participants in the Cancer Prevention Study II Nutrition Cohort to evaluate the influence of aspirin use on cancer mortality. The researchers found that daily aspirin use was associated with a modest 16% reduction in overall cancer mortality among study participants.

The authors wrote, “In this large prospective study, current daily aspirin use, updated during follow-up, was associated with modestly lower overall cancer mortality. The reduction in overall cancer mortality was driven by both a substantial reduction in mortality from gastrointestinal tract cancers and a small, but statistically significant, reduction in mortality from cancers outside the gastrointestinal tract”. In addition the authors noted, “Our results are consistent with an association between recent daily aspirin use and modestly lower cancer mortality but suggest that any reduction in cancer mortality may be smaller than that observed with long-term daily aspirin use in the pooled trial analysis. However, even a relatively modest benefit with respect to overall cancer mortality could still meaningfully influence the balances of risks and benefits of prophylactic aspirin use. Our results provide additional support for a potential benefit of daily aspirin use for cancer mortality, but important questions remain about the size of this potential benefit”.

Previous studies have also suggested that daily aspirin use can decrease cancer death rates, although the benefit that was found was much greater that the current study. We have previously discussed that daily aspirin use can help reduce the rate of colon cancer in a high risk population. This study suggests that the beneficial effects of aspirin in the prevention of cancer may be more widely applicable to the general population. Future studies will need to focus on the appropriate dosage and duration of aspirin treatment needed, and whether aspirin should be broadly recommended for the prevention of cancer. We must remember that aspirin can have toxicity, and more specifically can induce gastritis, gastric ulcers, and gastrointestinal bleeding. The overall risks and benefits of aspirin should be discussed with a personal physician before a daily regimen of aspirin is begun.

Reference:

Eric J. Jacobs et al. “Daily Aspirin Use and Cancer Mortality in a Large US Cohort” J Natl Cancer Inst (2012) doi:10.1093/jnci/djs318 first published online: August 10, 2012

Tagged as: acetylsalicylic acid, aspirin, cancer, Cancer Prevention Study II Nutrition Cohort, cyclooxygenase, Dr. Eric Jacobs, heart attack, stroke