Weekly aspirin cuts cancer risks

[Derf4223]

This is a link to a source I would not ordinarily cite, but the researcher comes up in serious papers elsewhere. If anyone can find a trial or reviewed article about it, that would be great.

thesun.co.uk/news/11407206/...

[JohnInTheMiddle]

Article in 2020 which seems high quality. Suggests that aspirin could be helpful against prostate cancer metastases. As a result of this and other research I'm taking a low dose aspirin everyday. Seems like it couldn't hurt - as long as I'm not in a car accident - heaven forfend.

sciencedirect.com/science/a...

[Tall_Allen]

In a small randomized clinical trial (RCT), aspirin has been shown to have no effect on prostate cancer:

thelancet.com/journals/lanc...

Moreover, aspirin has been shown in a very large RCT to increase all cancer-related deaths by 31%:

nejm.org/doi/full/10.1056/N...

[JohnInTheMiddle in reply to Tall_Allen]

Thanks for the shares TA. Two comments: (1) the first small RCT it's from 2016; (2) the second very large RCT seems amazing. How close reading reveals some interesting observation on cancer.

What I don't understand from the second paper is this statement: "1.6 excess deaths per 1000 person-years occurring in the aspirin group after a median of 4.7 years". I know enough about statistics to know that it's very easy to misunderstand the implication of some statistical claim. Naively reading this it seems that the ostensibly negative effect of aspirin is astonishingly small.

The other paper I posted claims that aspirin interferes with prostate cancer remote metastases colonization; I don't see that the above papers undermine this possibility.

[Tall_Allen in reply to JohnInTheMiddle]

"1) the first small RCT it's from 2016" So?

"What I don't understand from the second paper is this statement..." It is significant. An increase in 31% in cancer-related deaths!!

"The other paper I posted claims that aspirin interferes with prostate cancer remote metastases colonization; I don't see that the above papers undermine this possibility."

The paper you posted is just a review of retrospective and lab studies. Pretty much useless. GIGO.

Since STAMPEDE proved that COX2 inhibitors had no effect on PCa progression, interest in such drugs has waned.

Because of recent evidence that daily aspirin is harmful to CV health among healthy people, attitudes towards daily aspirin use has been changed.

academic.oup.com/eurheartj/...

[JohnInTheMiddle in reply to Tall_Allen]

I'm trying to understand the claimed 31% increase in deaths when aspirin is used. 1000 person years and approximately 5 years in the study implies that population of about 200. 1.6 excess deaths in a population of 200 is not a lot. Am I misunderstanding this?

[Tall_Allen in reply to JohnInTheMiddle]

The hazard ratio is 1.31

[Purple-Bike in reply to Tall_Allen]

About the Aspree trial showing higher cancer deaths from aspirin, linked to by TA: Some previous studies indicating anti-cancer effect of aspirin are of sufficient quality for the authors of the trial to write:

“Higher all-cause mortality was observed among apparently healthy older adults who received daily aspirin than among those who received placebo and was attributed primarily to cancer-related death. In the context of previous studies, this result was unexpected and should be interpreted with caution”. “Other primary prevention trials of aspirin have not identified similar results, which suggests that the mortality results reported here should be interpreted with caution”.

“In contrast to the ASPREE trial, meta-analyses of previous randomized prevention trials of aspirin have shown a protective effect of aspirin on cancer-related death, which became evident after 4 or 5 years of continuous therapy. Despite limited periods of intervention (typically ≤5 years), the preventive effect of aspirin was maintained for at least 15 years. There was also evidence of a lower risk of death from metastatic spread of cancer among participants who received aspirin than among those who received placebo.20 “

One possible reason for the discrepancy in results could be that the Aspree trial focused on persons 70 years and over:

“Strengths of the data on mortality in this trial (Aspree) include the size of the trial sample, particularly the large number of participants 70 years of age or older, and the access to clinical records, which allowed the underlying and proximal causes of death to be identified accurately in a high percentage of cases, despite the complex clinical scenarios that are common in this age group. The principal limitation is the limited follow-up period, which may have ended before the possible emergence of a preventive effect on cancer. The trial also focused on a specific age range and had limited statistical power on which to base firm conclusions about the effect of aspirin on mortality in subgroups of the U.S. population”.

I have been taking aspirin partly based on those other cancer studies, limiting it to 3x weekly to reduce bleeding risk. The contradictory results are baffling but being 70+ and finding out about the Aspree trial may make me reconsider. The Stampede results on CVD give additional cause to pause Aspirin intake.

[jlvincentjr]

Article appears to be based on a meta-analysis published in Annals of Oncology on 1 April 2020. May be found as a pdf file at

annalsofoncology.org/action...

I've not thoroughly reviewed manuscript, but as you might suspect, Sun article appears to be a bit of an oversimplification.

[j-o-h-n]

Number of deaths due to choking on the tablet?

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 07/08/2023 1:34 PM DST

[fast_eddie]

Well I've been taking a daily low dose aspirin for decades to diminish stroke risk from a-fib episodes. I continue with this regimen even after ablation surgery has all but cured my a-fib problem. It certainly didn't prevent me from developing prostate cancer, but what does?

[Mgtd]

Fasr-Eddie in answer to your question. I will share an old Italian cure for everything - garlic. Kind of like the Jewish - Chicken Soup. Aspirin, Chicken soup and garlic they are have proponents. Do they work? Depends on who you ask.

One thing I can attest to and can definitely say we never had a vampire near our house with the garlic around. LOL