The prospect that a cheap and relatively safe drug like aspirin could help reduce cancer risk has enticed researchers for decades. In the United States, tens of millions of adults take aspirin to reduce their risk of heart attack or stroke.
You can walk into any pharmacy, grocery or convenience store and buy aspirin, an over-the-counter (OTC) medicine, without a prescription.
Numerous studies have suggested that people who regularly take low doses of aspirin may have reduced risks of being diagnosed with or dying from cancer.
But new findings from a randomized clinical trial, called Aspirin in Reducing Events in the Elderly (ASPREE), a joint U.S and Australian research project, suggest that the same may not hold true for older adults.
The study included approximately 19,000 generally healthy people who were 70 years of age or older, and the primary results were published in September 2018.
This was a group of people starting to take aspirin when they were older. It’s unclear if the findings apply to people who begin taking aspirin regularly at an earlier age.
Furthermore, the U.S. Preventive Services Task Force (USPSTF), recommended that, for some people, aspirin can be used to help reduce their risk of cardiovascular disease and colorectal cancer.
However,
▪ The USPSTF has changed the age ranges of its recommendation on aspirin use. This recommendation applies to adults 40 years or older without signs or symptoms of cardiovascular disease (CVD) or known cardiovascular disease (CVD) and who are not at increased risk for bleeding (no history of gastrointestinal ulcers, recent bleeding, or other medical conditions, or taking medications that increase bleeding risk).
▪ The panel currently recommends considering initiating aspirin in persons with an estimated 10% or greater cardiovascular disease (CVD) risk at a younger age: 40 years instead of 50 years.
▪ Aspirin should be initiated selectively based on individual decision-making rather than routinely for all persons in the recommended age and cardiovascular disease (CVD) risk group. For patients initiating aspirin use, it would be reasonable to use a dose of 81 mg/day.
▪ There is a new recommendation not to initiate aspirin in adults 60 years or older for primary prevention.
And finally,
▪ The evidence is unclear whether aspirin use reduces the risk of colorectal cancer incidence or mortality.
Aspirin reduces the risk of cardiovascular events, but it increases the risk for gastrointestinal bleeding, intracranial bleeding, and hemorrhagic stroke.
For patients who are eligible and choose to start taking aspirin, the benefits become smaller with advancing age, and data suggest that clinicians and patients should consider stopping aspirin use around age 75 years.
The USPSTF considered 13 randomized clinical trials (RCTs) involving 161,680 participants that reported on the benefits of aspirin. Most trials used low-dose aspirin of 100 mg/d or less of aspirin every other day and included a balanced number of male and female participants and a broad distribution of ages.
More research is needed to evaluate the effects of low-dose aspirin use on colorectal cancer (CRC) incidence and mortality over the long term (10 to 20 years and longer) in primary prevention populations, and in the context of current colorectal cancer (CRC) screening practices.
There are effective screening tools for finding colorectal cancer early, when people may be more likely to survive it. Strategies to increase use of recommended screenings and to help people get physical activity and eat healthy are key to reducing the colorectal cancer death rate.
Your health professional will consider your current state of health. Some medical conditions, such as pregnancy, uncontrolled high blood pressure, bleeding disorders, asthma, peptic (stomach) ulcers, liver and kidney disease, could make aspirin a bad choice for you.
In 2023, roughly 2.0 million people will be diagnosed with cancer in the United States. An estimated 297,790 women and 2,800 men will be diagnosed with breast cancer, which makes it the most common cancer diagnosis.
Breast, lung and bronchus, prostate, and colorectal cancers account for almost 50% of all new cancer cases in the United States. Lung and bronchus, colorectal, pancreatic, and breast cancers are responsible for nearly 50% of all deaths.
Lung and bronchus cancer is responsible for the most deaths with 127,070 people expected to die from this disease, in 2023. That is nearly three times the 52,550 deaths due to colorectal cancer, which is the second most common cause of cancer death. Pancreatic cancer is the third deadliest cancer, causing 50,550 deaths.
In the meantime, all adults should consume a healthy diet that emphasizes the intake of vegetables, fruits, nuts, whole grains, lean vegetable or animal protein, and fish and minimizes the intake of trans fats, red meat and processed red meats, refined carbohydrates, and sweetened beverages.
For adults with overweight and obesity, caloric restriction are recommended for achieving and maintaining weight loss.
At least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity, is essential.
