Aspirin should be taken by all over 50s to cut thousands of cancer deaths: study

Every middle aged person should take aspirin daily for ten years, experts have said, as a comprehensive study has found it could save 6,000 lives a year by preventing cancer and heart disease .

Middle-aged adults should take aspirin every day for ten years, according to scientists who found it could save more than 6,000 lives a year by preventing cancer and heart disease

Daily aspirin can prevent up to one third of cancers of the bowel, throat and stomach and can halve the risk of dying in some cases, according to the the largest, most comprehensive analysis of the drugs use.

It comes after previous research raised concerns about the side effects of aspirin, which include bleeding and ulcers.

The new study found that while there was a small increased risk of a stroke, stomach bleeding and ulcers, the benefits of taking aspirin made it a “good bet”.

Experts said on balance taking aspirin was akin to taking out a pension, in that it was an investment in middle age that provided benefits later.

Advising otherwise healthy middle-aged people to take drugs to prevent later disease has proven controversial with some warning about medicalising old age. The majority of people taking aspirin would not see any benefit nor any harm from it.

Nevertheless the researchers said daily aspirin is now the most important way to prevent cancer after quitting smoking and losing weight.

Everyone aged between 50 and 64 should take a baby aspirin daily for ten years, they said.

This would save 6,518 lives from cancer per year, along with preventing 474 fatal heart attacks, but at the cost of causing an extra 896 deaths from stroke, stomach bleeding and ulcers, it was found.

Over 20 years the net number of lives saved would be almost 122,000 in the UK, the researchers from Queen Mary University of London found.

Anyone at high risk of bleeding should talk to their GP before taking aspirin, Prof Jack Cuzick said, including those on blood thinning drugs, with diabetes or smokers.

He said the benefits of taking aspirin for longer than ten years were more unclear and that the increased risk of bleeding was enhanced in those aged over 70. However the beneficial effects of aspirin last for years after stopping the drug, he added.

Prof Cuzick said: “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.

“The wise person would do both, improve their lifestyle and take aspirin but you can’t improve your lifestyle to the point that aspirin isn’t necessary.

“If the odds of preventing a death are substantially bigger than causing a death, then I think it is a good bet and at this stage we feel aspirin is a good bet.”

He said the figures included in the analysis were conservative and the benefits may be greater and the harms lower than suggested.

The study was partly funded by Cancer Research UK.

Dr Julie Sharp, head of health information at Cancer Research UK, said: “Aspirin is showing promise in preventing certain types of cancer, but it’s vital that we balance this with the complications it can cause – such as bleeding, stomach ulcers, or even strokes in some people.

“Before aspirin can be recommended for cancer prevention some important questions need to be answered, including what is the best dose and how long people should take it for. And tests need to be developed to predict who is likely to have side effects.

“Given the continued uncertainty over who should take aspirin, Cancer Research UK is funding a number of trials and research projects to make the picture clearer.

“Anyone thinking of taking aspirin should speak to their GP first.”

Prof Cuzick said the recommended dose was 75mg per day and that the risk of internal bleeding associated with aspirin could be cut by around one third by testing and treating anyone found to be carrying the infection, H.pylori in their stomachs.

The study, published in the Annals of Oncology looked at more than 200 research papers of different designs on the effects of aspirin on cancer and heart disease.

It as concluded that for every 1,000 people taking aspirin for 20 years there would be 17 lives saved and two deaths caused.

Several of the authors of the analysis declared that they have worked for the pharmaceutical industry connected to aspirin but that the findings and conclusions in the study do not represent their respective organisations.

Statin Treatment Linked to Fewer Cancer Deaths

Being treated for high cholesterol with statins is being linked with a reduced risk of death and better survival from four common cancers, a medical conference has heard.

The results come from a study of 14 years of UK data that included nearly a million people.

Cholesterol and Cancer

High cholesterol is known to increase the risk of heart disease, but less is known about the effect on the risk of developing cancer.

Previous research in animals found that giving statins for high cholesterol can reduce the risk of breast cancer, and researchers wanted to see if there was any effect of high cholesterol and its treatment on cancer deaths.

Anonymous information on people diagnosed for the first time with lung cancer, breast cancer, prostate cancer and bowel cancer was gathered from hospitals between January 2000 and March 2013.

Data on deaths from cancers came from the Office for National Statistics.

When researchers from several UK centres analysed the data, they found that people diagnosed with high cholesterol and one of the four cancers were less likely to die from cancer.

However, being diagnosed with high cholesterol usually lead to treatment, often with statins. So the researchers think the statin treatment might explain the protective effect, rather than high cholesterol itself.

They adjusted for other risk factors, such as age, gender, ethnicity, and other common causes of death.

Having a diagnosis of high cholesterol was linked to a:

22% lower risk of death in lung cancer

43% lower risk of death in breast cancer

47% lower risk of death in prostate cancer

30% lower risk of death in bowel cancer.

The study could only find a link between high cholesterol and a lower death risk, rather than establishing any cause-and-effect. However, high cholesterol has previously been linked with an increased risk of cancer, whereas animal experiments suggest that lowering cholesterol with statins may reduce it.

‘Exciting’ Findings

The findings were presented to the European Society of Cardiology Frontiers in CardioVascular Biology conference in Florence, Italy.

In a statement, lead author Dr Paul Carter from Aston Medical School, Aston University, says: “The discovery of a link between obesity and high cholesterol as risk factors for cancer has been exciting for researchers and the public.

“Even trendier is the idea that if high cholesterol can cause cancer, then cholesterol lowering interventions such as statins could reduce this risk.”

He continues: “Our research suggests that there’s something about having a high cholesterol diagnosis that improves survival and the extent to which it did that was quite striking in the four cancers studied. Based on previous research we think there’s a very strong possibility that statins are producing this effect.”
He believes these findings are also likely to be seen in other cancers, “but this is only speculation and would need to be confirmed by studies in different types of cancer.”

More Research Needed

Senior author Dr Rahul Potluri says it is possible other medications taken for heart-related conditions may also help with cancer survival. “Other cardiovascular medications may also be protective and explain the varying levels of risk reduction in the four cancer types. For example, prostate cancer is associated with heart disease and these patients tend to take ACE inhibitors and beta-blockers,” he says.

However, he cautions it is too soon to recommend statins alongside cancer treatment without a formal trial: “Patients with cancer who are at high risk or have established cardiovascular disease should be given statins as per current guidelines. I don’t think at the moment we can give statins for cancer per se. But this could change if there was a positive result in the clinical trial.”

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the ‘peer review’ process, in which outside experts scrutinise the data prior to publication in a medical journal.