Should I take aspirin?

 
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Should I be taking aspirin every day? It's a question that I hear frequently and I guess will hear even more often after the latest research from scientists at the University of Oxford.

In a series of papers in the Lancet, the team, led by Professor Peter Rothwell found that a daily low dose of the cheap drug cut the risk of a range of cancers, and could even treat the disease.

Most startling were findings which suggest that aspirin can prevent the spread of cancer. The chances that cancer had already spread by the time it was diagnosed were cut by almost a third. The risk of cancer spreading in those already diagnosed was cut by at least a half.

Prof Rothwell said: "Aspirin has a big effect on the spread of the cancer which is important as it's the commonest reason that cancer kills people. We found that after five years of taking aspirin there was a 30-40% reduction in deaths from cancer."

You can read more about the research here.

Previous research by Prof Rothwell and colleagues found that daily aspirin use cut overall cancer deaths by a fifth over twenty years.

We already know that people at high risk of heart disease and stroke are often recommended to take aspirin for its protective effects.

An initial glance of the three papers would seem to tip the balance in favour of healthy middle-aged people popping a daily low dose (75mg) of aspirin.

A commentary by Andrew Chan and Nancy Cook from Harvard Medical School, described the research as "compelling" even though it did not include the two huge studies which did not show a reduced risk of cancer incidence or deaths after a decade of follow-up. These papers were excluded because they involved volunteers taking aspirin on alternate days.

I was contacted by Professor Janusz Jankowski, from Queen Mary, University of London, who is conducting a separate trial involving 2,500 patients looking specifically at aspirin and cancer prevention.

The trial is not yet published but Prof Jankowski said after more than four years follow-up they had found "zero" benefits. These are clearly disappointing results but such negative findings are unlikely to attract the same fanfare as Rothwell's positive outcome.

The elephant in the room with aspirin is internal bleeding. The dangers of bleeds, including in the stomach, intestines and brain are well-known. It's these adverse effects - which can be serious and even fatal - which have prevented doctors from recommending daily aspirin for healthy middle-aged people.

Prof Rothwell thinks it is time for guidelines to be reviewed in the wake of the evidence on cancer prevention.

I suspect many people may take the decision into their own hands. Cost is not an issue here - aspirin is about the cheapest drug there is - little more than a penny a pill.

But healthy adults considering daily aspirin need to know the potential risks and that they will effectively be medicalising themselves for many years as the benefits come from long-term use.

I wrote about my personal decision to take aspirin back in December 2010 when the first raft of Rothwell research came out.

In January 2012 I was asked whether I was still taking it, after medical trials showed that for those without a history of heart disease or stroke, aspirin was more likely to do harm rather than good.

I said I was, partly because I knew this new Rothwell research was due at some point. But for anyone still interested I have recently stopped because of a - as yet undiagnosed - gut complaint. I will talk to my doctor - and maybe have another look at the mounting research on this issue - before deciding whether to continue with aspirin.

Those without the time or inclination to wade through research papers should be helped in due course by further research on the risks and benefits of aspirin. But don't expect a simple, quick or straightforward answer to the question: "should I take aspirin every day?"

 
Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this
    +1

    Comment number 22.

    It may help some people, it may be detrimental to others (as with all medicines). speak to your GP first - it really is that simple.

  • rate this
    +1

    Comment number 21.

    I'm sure I saw a survey recently that suggested an aspirin a day wasn't too good for you? I wonder if one day we'll get some unadulterated statistics analysed by someone without an agenda....

  • rate this
    0

    Comment number 20.

    I've never been able to take aspirin since childhood as I discovered the first time I took it I have quite a severe allergic reaction to it.
    It's rare to be allergic to aspirin but there must be others like me, who cannot get the usual health benefits from it.

  • rate this
    0

    Comment number 19.

    4.Moonraker
    Surely it couldn't be because they receive an 'incentive' from big pharma, could it?
    -----
    Asprin has been generic for decades. You can buy hundreds of tablets for a few pounds. No-one is making a fortune from overpricing Asprin.

  • rate this
    +1

    Comment number 18.

    a historian, an engineer and a statistician are duck hunting. a duck rises from the lake. the historian fires first, and shoots 10' over the duck. then the engineer shoulders the shotgun and shoots 10' under the duck. the statistician exclaimed "got him!".

    "do you like statisticians?" "probably."

  • rate this
    +1

    Comment number 17.

    Considering that yesterday you ran a headline stating that Aspirin lowered the risk of cancer, then the answer is quite obviously yes - unless you're now admitting that the previous story was a load of rubbish. In which case, the question should probably be "Should I believe the BBC?"

    We don't need two consecutive debates on aspirin - we STILL haven't been offered a debate on Richard O'Dwyer.

  • rate this
    0

    Comment number 16.

    Asprin would be banned if it was invented today

    Too many side effects

  • rate this
    0

    Comment number 15.

    My 96 year old grandmother has taken 1/2 an Asprin every day for I don't know how long! Perhaps there may be some truth in this, but one cannot help think that the many companies producing Asprin will benefit greatly! I too, would like to see an independent statistician review both sets of results.Like Dr Stanislaw Burzynski, a targeted & taliored medication for the individual should be perscribed

  • rate this
    0

    Comment number 14.

    one solution would be to make coated aspirin more widely available, appropriately coated aspirin dissolves in the gut significantly reducing the risk of stomach issues. most over the counter aspirin is not coated. it would push the price up though.

  • rate this
    +2

    Comment number 13.

    I would like to see an independent statistician review both sets of results
    ----

    No such thing

    There are those who are paid by government
    There are those who are paid by the lobbying industries

    You can occasionally run into a truly independent statistician in the street, he has a sign "hungry and homeless" pinned to his chest

  • rate this
    0

    Comment number 12.

    Daily aspirin is part of my daily medication for helping to control cholesterol and together with a modest dose of statin it does seem to work. Too much statin causes stiff joints particularly knee joints which as a hiker I cannot abide so I take Cod Liver Oil capsules and try to get the right balance. Eventually all our earthly bodies wear out but our Heavenly bodies don't.

  • rate this
    0

    Comment number 11.

    I'm so glad I wasn't born an aspirin. Over the years it has been practically banned from the shelves and praised as being the wonder drug of the century.
    It must be very confusing for the poor thing.

  • Comment number 10.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +1

    Comment number 9.

    The problem is that the drug-industry (££££) puts ££££ befor health, foiling alternatives and fixing prices.
    Quelle suprise.

  • rate this
    0

    Comment number 8.

    I only take asprin if I'm going on a long haul flight to reduce the chances of DVT.

  • rate this
    0

    Comment number 7.

    Yeah, why not....

  • rate this
    +1

    Comment number 6.

    I am prescribed an aspirin (75 ,g) a day. With the information re benefits and adverse effects changing almost daily I guess I have to trust my GP's judgement as she is far more qualified to weigh up the pro's and con's than me.

  • rate this
    +1

    Comment number 5.

    I have been taking a natural product called FruitFlow that is the only natural product with EFSA approval that reduces platelet aggregation. It therefore does the same job as aspirin without the risk of the internal bleeding possible with aspirin. Maybe it will have the same affect on cancer as described in this latest report.
    Has anybody else tried FruitFlow?

  • rate this
    0

    Comment number 4.

    Surely it couldn't be because they receive an 'incentive' from big pharma, could it?

  • rate this
    +2

    Comment number 3.

    Mr. Walsh, re this quote:

    "In Jan '12 I was asked whether I was still taking it, after medical trials showed that for those without a history of heart disease or stroke, aspirin was more likely to do harm rather than good."

    We have *precisely* the same information for statins - no benefit w/no prior heart attack/stroke, yet drs push them in spite of risks for rhabdomyolysis, diabetes, etc. Why?

 

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