
An aspirin a day keeps many cancers away, study suggests - perseusprime11
http://www.telegraph.co.uk/science/2017/10/30/aspirin-day-keeps-many-cancers-away-study-suggests/
======
idclip
I take aspirin protect, made by bayer. Grandad and dad had heart issues, so my
dr started me a while ago on it as to curb the risks.

An aspirin a day will also make your nose bleed after a few weeks. Albeit not
profusely but if you blow your nose, you will see blood.

take one every 3rd say. Unless its a very small dosage with delayed release.

Aspirin should not be messed with, make sure you eat before you take a pill,
or itll tear a hole in your stomach. Ive made that mistake once a decade ago.

Please consult your doctor before grabbing off-the-counter aspirin.

~~~
masklinn
> An aspirin a day will also make your nose bleed after a few weeks. Albeit
> not profusely but if you blow your nose, you will see blood.

Should depend on dose and physiology: for low doses (below ~4g) the half life
of aspirin is 2 to 4.5h depending on the person. If you saturate the metabolic
pathway however the half-life shoots up to 15~30h.

> take one every 3rd say. Unless its a very small dosage with delayed release.

The study was done with _80mg_ aspirin daily (sometimes called "baby"
aspirin). Standard adult dose around here is 500mg.

~~~
idclip
My experience is with 100mg delayed release over 10 years.

And jesus, 500mg? Holy crap

~~~
notanote
As far as I know, the over the counter 500mg dose is sold over here as a
painkiller, it's certainly not meant for long term preventative use.

~~~
masklinn
> the over the counter 500mg dose is sold over here as a painkiller, it's
> certainly not meant for long term preventative use.

Most def', but if you ask for aspirin without specifying any further that's
what you get (that's what I'm given every time anyway). I'm not sure you can
even get 75~80mg, 100mg seems to be the lowest dose available (for long-term
use after infarction & stuff, and for toddlers).

~~~
echion
In the US and UK one can get ~80mg (75, 81) OTC, at any drug store / chemist.

------
mishkovski
>If taking aspirin were without side-effects and completely risk free, it
might make sense for everyone with heart disease, or just worried about it, to
take it. But aspirin does have risks. Reducing blood's clotting potential can
lead to hemorrhagic stroke (bleeding inside the brain). In the stomach,
aspirin can cause everything from a feeling of mild heartburn to bleeding
ulcers. Severe gastrointestinal bleeding can be deadly.

[https://www.health.harvard.edu/healthbeat/should-everyone-
ta...](https://www.health.harvard.edu/healthbeat/should-everyone-take-an-
aspirin-a-day)

~~~
MarkMc
Even _with_ the side effects and risks it might make sense for almost everyone
who is aged 60 to take aspirin every day.

There is now good evidence [1] that if 10,000 people aged 60 took aspirin for
20 years there would be:

174 fewer deaths from cancer and heart attacks

24 more deaths from strokes, ulcers and gastric bleeds

So it seems that the benefits far outweigh the costs.

[1]
[http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-a...](http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-
and-cancer-not-quite-but-nearly/)

------
chewyshine
Just an abstract. Limited or no peer review so be careful. Here's the text.

Background: Chemopreventive effect of aspirin on colorectal cancer (CRC) has
been reported, but there are indications that effects of aspirin are not
limited to the colon or rectum. The aim of this study is to evaluate the long-
term use of low-dose aspirin at 80mg for other gastrointestinal (GI) cancers.
Method: A territory-wide dataset which includes all patients admitted to
public hospitals of Hong Kong were used to extract a cohort between 2000 and
2004 with long-term use of aspirin and matched against non-aspirin users in
1:2 ratio. Further matching on survival time with duration of aspirin
prescribed for at least 6 months was conducted to avoid immortal bias.
Patients' outcomes were documented for up to 14 years until 2013. Changes in
cancer incidences on colon/rectum, liver, oesophagus, pancreas and stomach
were the primary outcomes. Cancer related mortalities were the secondary
outcomes. Odds ratio (OR) was used to measure the cancer incidence, and Sub-
distribution Hazard Ratio (SHR) for competing risk mortality was fitted to
adjust for other cause-ofdeath. Results: A total of 618,884 subjects were
included; 206,295 aspirin users with average aspirin prescribed for 7.7 years
were matched with 412,589 non-aspirin users. The mean ages of patients in
aspirin and non-aspirin group were 67.5 years and 67.6 years respectively. The
median dose of aspirin prescribed was 80mg, and inter-quartile range was from
80 mg to 100 mg. A total of 18,500 (2.99%) cases of CRC, 9,433 (1.52%) of
hepatic cancer, 2,658 (0.43%) of oesophageal cancer, 2,796 (0.45%) of
pancreatic cancer, and 5,877 (0.95%) of gastric cancer were observed. Long
term used of low-dose aspirin showed significant reduction on cancer
incidences for CRC (OR:0.76, 95% CI:0.73-0.78), hepatic cancer (OR:0.53, 95%
CI:0.51-0.56), oesophageal cancer (OR:0.53, 95% CI:0.49-0.59), pancreatic
cancer (OR:0.66, 95% CI:0.60-0.71), and gastric cancer (OR:0.62, 95%
CI:0.58-0.65). Long term used of low-dose aspirin also showed significant
reduction on mortality from GI cancers (Table 1). Conclusion: Long-term use of
low-dose aspirin, at 80mg, significantly reduced both incidence and mortality
from colorectal, hepatic, oesophageal, pancreatic and gastric cancers.

~~~
rodrigosetti
It’s not double blind. Aspirin takers might have other correlated behaviors
which reduces cancer risks

------
macawfish
In case you don't like pill popping, remember that many foods contain natural
salicylates, including salicylic acid itself.

[https://www.ncbi.nlm.nih.gov/pubmed/11493722](https://www.ncbi.nlm.nih.gov/pubmed/11493722)

~~~
52-6F-62
Great tidbit.

The advice always seems to come back to: "EAT YOUR DARK GREENS ALREADY!"

Spinach goes into my eggs every morning, and my poor girlfriend has suffered
enough fresh salads with cucumber, broccoli and onion at my hands that she's
come around to liking them — looking forward to them, and even _requesting_
them. My god.

Eat your spinach!

~~~
macawfish
Yes! And just remember, spinach is very healthy for you so long as your
calcium/magnesium situation is balanced and you're drinking enough water and
are moderate with caffeine/alcohol!

Spinach will help your urinary tract do what it's designed to do, but it needs
_your help_!

------
zenon
Aspirin is metabolised to salicylic acid (SA) in the body. SA is a plant
hormone found in many common food plants. I wonder if some of the health
benefit of a plant-heavy diet can come from the SA. Maybe we are adapted to a
certain level of SA intake, and eating aspirin helps us fulfill our SA
"requirement" ... and then some, a baby Aspirin gives us 10-100x as much SA as
a day's worth of plant-based food.

~~~
Balgair
SA is also the active ingredient in wart removal balms, so there's that. Bio
is SUPER complicated and really can't be reduced to first principals outside
of breathe, drink, eat.

~~~
akeck
Breath, drink, eat, sleep?

~~~
dotancohen
What, no code?

------
nathan_long
> [blah blah blah], study suggests

Nobody outside medical research should pay the slightest attention to to
anything _a_ study _suggests_ , especially not if they're ignoring what _many_
studies _give strong evidence for_.

Nothing to see here.

~~~
matt4077
I'm possibly misreading you here... But:

You do know that it's not literally a study walking up to some journalist,
speaking the words "I suggest some Aspirin!", right?

...because you seem to put some rather misplaced importance on the exact
phrase used to introduce the study.

~~~
nathan_long
Yes, I'm aware that studies do not converse with people.

When someone says a study "suggests" something, I understand them to mean that
it gives very tentative evidence. Such evidence is frequently contradicted by
other studies: see [https://www.sciencealert.com/images/art-
apr-15/Medical_studi...](https://www.sciencealert.com/images/art-
apr-15/Medical_studies-05.0.png), which another commenter has linked.

If one study suggests that eggplants may prevent heart disease, you can pretty
much bet that another will suggest it causes it.

That's why I'm saying to ignore this. We would all do well to eat better and
exercise more, suggestions that are well-supported by many studies. If we're
not doing that, we're certainly wasting our time on uncertainties like this.

------
tyingq
The close to 40% reduction (for several types of cancer) is pretty dramatic.
And the breadth of the study (600k patients) seems reasonable.

Is this really big news, or some skewed view of a study?

~~~
ekianjo
> Is this really big news, or some skewed view of a study?

Observational studies about the so-called benefits of aspirin come several
times a year. But hey, why don't they put it in actual clinical trial instead,
if they are SO confident it works so well?

~~~
ramblerman
Clinical trials for cancer prevention would mean 20-50 years no? That's a
pretty big undertaking.

I mean you would need a control group and a real one, and then just wait ...
for a long time

~~~
dekhn
no. Cancer trials take a few years. You don't need to wait for everybody to
get cancer, because small numbers of people get cancer stochastically every
year.

------
rdtsc
Or people who care enough to take an aspirin a day probably also take care of
themselves better in other ways, which might be what keeps the cancer away?

~~~
prodtorok
What if they are hypochondriacs filled with anxiety and stress? -- feel like
these people would definitely take an asprin a day out of fear.

------
dvfjsdhgfv
So why don't we all take acetylic acid? Because as all blood diluents it can
have dramatic consequences - a hemorrhage. Also, if you have an accident,
things can get quite complicated. That's why a doctor will prescribe acetylic
acid only if the benefits outweigh the risks - which is not always easy to
assess.

~~~
LinuxBender
I take aspirin on a regular cadence and have tinnitus as a fun side effect.
This is actually quite common [1] but you won't hear a doctor giving that
warning. No pun intended.

[1] [http://www.arthritis.org/living-with-
arthritis/treatments/me...](http://www.arthritis.org/living-with-
arthritis/treatments/medication/drug-types/analgesics/pain-drugs-hearing-loss-
men.php)

~~~
copperx
Some commmon drugs cause hearing loss (ototoxic), but this is rarely mentioned
by doctors. I guess hearing isn't considered as important as sight.

~~~
LinuxBender
In my case, hearing loss is less of a problem than closing off of the
arteries. I'm going as far to experiment with off-label 2-hydroxypropyl-Beta-
Cyclodextrin which can also cause hearing loss. My only point is that people
should not take aspirin unless they have a medical need to do so that
outweighs the risk of hearing loss.

~~~
tormeh
But what dosage are you on? Say I use a pill cutter and take half a baby
aspirin a day (40-50mg). Do I risk hearing loss?

~~~
copperx
There are papers on PubMed that can point you in the right direction on that;
but I just wanted to point out that if you get a DNA test (23andme and
others), you get tested for a mutation that makes stomach bleeding more likely
if you take aspirin. So the answer to both may be "it depends on your genes."

------
topbanana
Correlation or causation?

Interestingly, the cancers that are most lifestyle related (liver, lung) are
the ones seemingly most affected by taking aspirin.

Perhaps those taking aspirin are simply taking better care of themselves?

~~~
gwern
There are meta-analyses of the RCTs for baby aspirin which also indicate
reductions in all-cause mortality probably through its effect on cancer rates.
I'd consider them much more important than this result which is ultimately
just another correlational/observational result. Some of the studies I'm
thinking of:

\- Rothwell et al 2012 "Short-term effects of daily aspirin on cancer
incidence, mortality, and non-vascular death: analysis of the time course of
risks and benefits in 51 randomised controlled trials"
[http://www.istudymedicine.com/wp-
content/uploads/aspirin.pdf](http://www.istudymedicine.com/wp-
content/uploads/aspirin.pdf)

\- "Effect of daily aspirin on long-term risk of death due to cancer: analysis
of individual patient data from randomised trials"
[http://www.beppegrillo.it/immagini/Aspirin%20and%20death%20f...](http://www.beppegrillo.it/immagini/Aspirin%20and%20death%20from%20cancer%20\(Lancet%202010\).pdf)

\- "Aspirin for prophylactic use in the primary prevention of cardiovascular
disease and cancer: a systematic review and overview of reviews"
[https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0083409/](https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0083409/)
, Sutcliffe et al 2013

\- Pignone et al 2013, "Effect of including cancer mortality on the cost-
effectiveness of aspirin for primary prevention in men"
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797356/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797356/)

\- "Estimates of benefits and harms of prophylactic use of aspirin in the
general population", Cuzick et al 2014
[http://annonc.oxfordjournals.org/content/26/1/47.full](http://annonc.oxfordjournals.org/content/26/1/47.full)

\- Cuzick et al 2015, [Estimates of benefits and harms of prophylactic use of
aspirin in the general population"
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269341/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4269341/))

------
MarkMc
Here are two more studies suggesting that aspirin reduces cancer [1] [2]. The
second is from 2014 but is particularly compelling because it assessed whether
the drop in cancer was worth the increased risk of stomache bleeding.

The head of that study said that taking aspirin "looks to be the most
important thing we can do to reduce cancer after stopping smoking and reducing
obesity, and will probably be much easier to implement"

[1] [https://www.scientificamerican.com/article/aspirin-may-
preve...](https://www.scientificamerican.com/article/aspirin-may-prevent-
cancer-from-spreading-new-research-shows/)

[2] [http://www.theguardian.com/science/2014/aug/06/aspirin-
could...](http://www.theguardian.com/science/2014/aug/06/aspirin-could-
dramtically-cut-cancer-risk-say-scientists-biggest-study-yet)

------
jonnycomputer
Unless you have strong preferences on the diseases you end up getting, isn't
the important thing aspirin's effect on total all-causes morbidity/mortality?

------
matthewrudy
Cancer Research UK has great articles on taking aspirin both to prevent cancer
[1], and to prevent the spread and recurrence of cancer [2]

Their tweets [3] today on the topic lay out the current situation pretty
clearly

Quoting their tweets and blog post:

"Aspirin can help protect against bowel cancer, and possibly stomach,
oesophageal and other cancer too"

"Aspirin also increases the risk of strokes and stomach bleeding"

"the benefits start building from age 50, so there’s little to gain from
taking it below that age"

[1]
[http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-a...](http://scienceblog.cancerresearchuk.org/2014/08/06/aspirin-
and-cancer-not-quite-but-nearly/)

[2] [http://about-cancer.cancerresearchuk.org/about-
cancer/cancer...](http://about-cancer.cancerresearchuk.org/about-
cancer/cancer-in-general/treatment/cancer-drugs/aspirin-and-secondary-cancer)

[3]
[https://twitter.com/CR_UK/status/925323615360487425](https://twitter.com/CR_UK/status/925323615360487425)

~~~
MarkMc
I find the advice given by Cancer Research UK in your first link quite
strange.

They seem to accept that if 1000 people aged 60 took aspirin for 20 years
there would be:

17.4 fewer deaths from cancer and heart attacks

2.4 more deaths from strokes, ulcers and gastric bleeds

That's a net reduction of 15 deaths per 1000 people. Yet before they recommend
that everyone aged 60 take aspirin, they want to know:

a) What age should people start, and stop, taking aspirin?

b) What dose should they take?

c) What are the factors that should rule someone out from taking aspirin, and
how should we test for them?

Here are my answers to Cancer Research UK:

a) People whose age would put them within the study cohort. From my reading
this is at least people aged 60 for 20 years

b) They should take the dose that was looked at in the study

c) We don't know what factors should rule someone out, but until we do know we
should recommend aspirin to everyone who would have been within the cohort
study.

There are probably around 10 million people aged 55-65 in the UK. 15 extra
deaths per 1000 people means an extra 150,000 deaths over 20 years.

So the cost of waiting for more studies is about 7 extra deaths _per day_ in
the UK alone. Cancer Research UK is being too hesitant in its recommendations.

------
primroot
[https://en.wikipedia.org/wiki/Essential_fatty_acid_interacti...](https://en.wikipedia.org/wiki/Essential_fatty_acid_interactions)
. Some recommended keywords that are not mentioned in the article:
inflammation, essential fatty acids (EFA), and the Arachidonic Acid Cascade.

A feature that significantly distinguishes modern diets, especially after the
advent of "vegetable" oils and grain-fed meat, is the ratio of omega-6 to
omega-3 (the two types of EFA).

Aspirin works by irreversibly inactivating the cyclooxigenase enzyme, which is
involved in the Arachidonic Acid Cascade.
[https://en.wikipedia.org/wiki/Mechanism_of_action_of_aspirin](https://en.wikipedia.org/wiki/Mechanism_of_action_of_aspirin)

Edit: Added last parragraph.

------
padraigf
From what I can see, there's no control-group, so it's showing correlation,
and not causation.

I read that people who floss daily live longer too. It's not because they
floss, but the ones who floss are more likely to have healthier lifestyles in
general. This study seems to fit into the same bracket.

------
nikolay
Most of the negative effects of Aspirin can be countered by combining it with
vitamin C [0]. In Europe, there are several combinations (Aspirin-C or Upsarin
C) and the effervescent versions are especially nice.

[0]: [https://www.huffingtonpost.com/leo-galland-md/aspirin-and-
vi...](https://www.huffingtonpost.com/leo-galland-md/aspirin-and-vitamin-c-
tog_b_529058.html)

------
S_A_P
Aspirin always makes my stomach hurt terribly. Even low dose aspirin makes me
feel like I have an ulcer. I wish I could take it...

~~~
yawz
I hear you... I'm in the same boat. I've tried it many times, but my stomach
wasn't happy about it.

------
iask
I ate an entire box of baby aspirin when I was a kid. Seriously. I clearly
remember hiding under the bed while crunching away. Nothing happened.

Come to think of it, I got the flu twice in 30 years.

~~~
Traubenfuchs
Study suggests that consuming an entire box of baby aspirin causes reoccurring
flu.

------
nik736
I can see this being true. Also Xarelto and other drugs that can be used to
prevent strokes are good for some things but the cons outweighs the pros for
sure.

------
nik61
Beware also that Aspirin allergy is a thing and often accompanies a general
allergy to NSAIDs such as Ibuprofen. In my own case the allergy results in a
moving facial swelling (angioedema) which my family dubbed 'Quasimodo Face'
before we realised the cause. This effect lasted a day. I had it a few times
before I worked it out. The allergy came on after a period of work stress and
minor illness where I was taking Ibuprofen to get through the day.

------
Gustomaximus
I really look forward to big (hopefully open data) and health services to
merge more. This could be one of the great wealths of information for the 21st
century to progress health and treatment.

If the governments put half as much effort into spying on our heath decisions
and putting that data out there I'm guessing it would save more lives than
current efforts!

------
acqq
The abstract of the study is here:

[http://www.gastrojournal.org/article/S0016-5085(17)30803-X/a...](http://www.gastrojournal.org/article/S0016-5085\(17\)30803-X/abstract)

------
bolololo1
Who was the study sponsor?

------
ekianjo
Please post something more substantial. No links to the actual papers, no
proper summary of how the data was generated (who they recruited, etc...), in
other words it's blogspam at best.

~~~
tyingq
The actual paper is locked up in Elsevier.
[http://www.gastrojournal.org/article/S0016-5085(17)30803-X/p...](http://www.gastrojournal.org/article/S0016-5085\(17\)30803-X/pdf)

