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Long-term aspirin may cut risk for cancer death

Wednesday, April 5, 2017

This is an excerpt of a story that appeared in Medscape Medical News. Read the full article here. 

Photo of Manish Shah, M.D. Long-term, regular aspirin use was associated with both a reduced relative risk for death from any cause and also death from cancer,  according to a new observational study involving more than 130,000 health professionals.

Overall mortality risk was 7% lower for women and 11% lower for men who regularly used aspirin compared with nonregular aspirin users. And cancer mortality risk was 7% lower for women and 15% lower for men who regularly used aspirin.

The median follow-up time was 32 years.

The new results were reported by  Yin Cao, MPH, ScD, from the Massachusetts General Hospital in Boston, and colleagues in a presentation here at the American Association for Cancer Research (AACR) 2017 Annual Meeting.

Aspirin was beneficial at doses of at least 0.5 to 1.5 standard tablets per week for both men and women. The minimum duration of regular use associated with lower cancer mortality was 6 years, the authors note..

"The reductions in the risk of cancer death may seem modest but the effect size is comparable to the increase in the risk of cancer death associated with obesity," Dr Cao told Medscape Medical News.

The team studied 86,206 women enrolled in the Nurses' Health Study between 1980 and 2012, and 43,977 men enrolled in the Health Professionals Follow-Up Study between 1986 and 2012. In each study, aspirin use was assessed at baseline and every 2 years afterward.

"It's compelling data," said Manish Shah, M.D. a gastrointestinal oncologist at Weill Cornell Medicine and New York-Presbyterian Hospital in New York City.

However, Dr Shah, who was not involved in the study, also observed that the gold standard of evidence is a prospective, randomized trial.

"These kind of cohort analyses can have significant biases," he said. "Part of the effect may be due to the fact that aspirin users may be more health conscious overall."

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Additional coverage:

Long-term Aspirin Use Reduces Risk of Major Cancers - Cancer Therapy Advisor

“This was a very, very interesting study,” Manish Shah, M.D., a gastrointestinal oncologist at Weill Cornell Medicine and New York-Presbyterian, New York, who was not affiliated with the study, told Cancer Therapy Advisor, “because it suggests for the first time that such an inexpensive drug can reduce not only the incidence of polyps and cancers, but it may also improve non-cancer survival.”

According to Dr Shah, the reason for this benefit is “presumably by reducing inflammation although there are likely other mechanisms.”

Dr Shah also noted that “even though the investigators did a very good job controlling for everything they could, we should remember that this is not a randomized trial, so there may be inherent biases that we can't control for.”