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PostPosted: 07 Aug 2014 21:23 
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GPs can advise people over 50 to take aspirin daily to help cut deaths from cancer, UK academics have claimed after carrying out a review of the latest evidence.

The researchers said that for people aged 50–65 years, taking a low daily dose of aspirin – between 75 and 100 mg – cut the risk of dying from cancer over the next 20 years.
People would need to take aspirin for five years or longer, but – at least for this age group – the benefits outweighed the risks from potential bleeding, according to the team.

The researchers said daily aspirin was the next best approach to preventing cancer for the population ‘after stopping smoking and preventing obesity’ but called for people to ask their GP before taking aspirin daily as ‘there are some serious side effects that can’t be ignored’.

However, leading GPs and experts in cancer research warned more evidence was needed regarding which patients should be targeted for aspirin prevention before GPs could advise people to start taking a daily dose.

The review - published today in the Annals of Oncology - was carried out by an international team led by Professor Jack Cuzick, from Queen Mary University of London, with backing from Cancer Research UK and the British Heart Foundation.

Overall, studies showed aspirin cut the risk of colorectal cancer deaths by around 40% over 10 years, and oesophageal and stomach cancer deaths by 35-50%.

The benefits were seen for aspirin 75-100 mg daily if taken for at least five years between the ages of 50 and 65; no benefit was seen for the first three years and death rates were only reduced after five years.


However, the risks of bleeding – particularly from the digestive tract – were significantly increased with daily aspirin use.
For example, in people aged 60 years taking daily aspirin increased the risk of gastrointestinal bleeds from 2.2% to 3.6%, although the authors say this would be potentially life-threatening in a small proportion (less than 5%).

Based on the evidence, the authors calculated that for average-risk people aged 50-65 years, taking aspirin daily for 10 years would cut the risk of cancer, heart attack or stroke by 7% in women and 9% in men over 15 years and lead to a 4% overall reduction in deaths over 20 years – almost entirely due to a reduction in cancer deaths.
They calculated that despite the increase in bleeding risk, for people in this age bracket the net benefit in reduction of deaths favoured treatment.

However, the review authors cautioned that it remains unclear what dose of aspirin is best to maximise the benefit-to-harm ratio, or whether taking aspirin longer than 10 years would result in greater benefits.

But lead author Professor Cuzick said he believed the benefits of daily aspirin would outweigh the harms for most people and the risk of bleeding could be assessed on an individual basis.

Professor Cuzick said: ‘Until our study, where we analysed all the available evidence, it was unclear whether the pros of taking aspirin outweighed the cons.’

‘Whilst there are some serious side effects that can’t be ignored, taking aspirin daily 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.’

He added: ‘The risk of bleeding depends on a number of known factors which people need to be aware of before starting regular aspirin and it would be advisable to consult with a doctor before embarking on daily medication.’

ANN. of ONCOLOGY 6th August 2014.

G Mohan.


Last edited by gmohan on 12 Aug 2014 03:15, edited 1 time in total.

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PostPosted: 10 Aug 2014 12:43 
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Hi Mohan
I am a little disinclined to agree with this report. Earlier in this forum when commenting on a report by our friend Badri that exercise a few minutes a day increases the longevity, I had wondered that without knowing in advance the length of our life, how can we say that we could lengthen the life one individual. Same argument may be raised here. How do you know in advance that this particular person is going to get cancer and later we claim that we could prevent cancer in this individual. Unless you have some genetic proof I don't think it is possible at all to label a person to be in a precancerous state. Unlike other diseases like hypertension, diabetes and atherosclerosis we are still searching for the cause of cancer. Statistically we can enumerate certain triggering factors like smoking. Cancer is essentially an altered physiology of cells. In every individual each cell is under genetic control for the division and multiplication. Each cell stops growing at a particular level when it reaches the predetermined position. For example, if not stopped, our eyebrows would have grown covering our face and body. In cancer, this control over the growth is lost, the cause of which is still to be established beyond doubt. Then where is the question of preventing cancer?

Hi Mohan, hope you would not be out with me for this type of approach from your friend. Expect your rejoinder.

UA Mohammed


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PostPosted: 11 Aug 2014 03:44 
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Good to hear from you Mohammed.
What you have raised is called ' SCIENTIFIC CRITICAL APPRAISAL'.

I sincerely hope all our younger colleagues out there , rise to this type of ENQUIRY.

regarding the study ,i brought this up , for 2 reasons.
1. In UK, some people have started taking Aspirin , after reading about this study in the Newspapers !!. This is quite wrong and may even be very harmful.

2. The evidence is incomplete and more research is needed , including Double blind Randomized long term follow up.

The ESTIMATES made in this study were based on Prevelances and Incidences for age matched groups.

Keep up the good work Mohammed, for being an example to our younger colleagues.

Kind regards,

G Mohan.

See below for the NHS UK assessment.


Last edited by gmohan on 11 Aug 2014 03:50, edited 1 time in total.

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PostPosted: 11 Aug 2014 03:49 
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NHS Choices whic advises the public, has published an assessment of this study, as it has been featured widely in the press .

This notes that it is unclear whether this was a systematic review, and that the researchers did not carry out a meta-analysis, but compiled their own estimates. Studies of varying design and quality were included.

The authors of the assessment conclude that “While the findings on aspirin and cancer show promise, it is not clear that the results are reliable from the methods reportedly used to compile this review.”

G Mohan.


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PostPosted: 11 Aug 2014 06:55 
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Hi Mohan & Mohammed,

GI bleeding and GI symptoms are very common and the bleeding could be very serious. I advise my patients not to take aspirin unless recommended by a cardiologist or neurologist.

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Raghuthaman


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