The aspirin wars — definite risk and potential benefit

The idea that aspirin might be able to prevent prostate cancer is not new, but a recent paper has re-stirred the controversy about the relative risks and benefits of aspirin as a preventive agent.

In their paper in the American Journal of Epidemiology, Salinas et al. report data from a population-based, case-control study designed to investigate the relationship between the use of aspirin,  the use of other non-steroidal anti-inflammatory drugs (NSAIDs), and prostate cancer risk

They analyzed data on the use of aspirin and other NSAIDs by 1,001 men diagnosed with prostate cancer between January 1, 2002 and December 31, 2005, and another 942 age-matched controls. All patients were resident in King County, Washington.

The results of their analysis showed that:

  • There was a 21 percent reduction in the risk of prostate cancer among the users of aspirin compared with the aspirin non-users.
  • Use of aspirin  for > 5 years decreased risk for prostate cancer (odds ratio = 0.76).
  • Daily use of low-dose aspirin also decreased risk for prostate cancer (odds ratio = 0.71).
  • The effect of aspirin use did not appear to be modified by the aggressiveness of the patient’s disease.
  • Prostate cancer risk was not affected by use of acetominophen or other NSAIDs.

However, there have been other studies that produced less definitive data about the potential of aspirin and NSAIDs in the prevention of prostate cancer (see, for example, this review by Perron et al.). As a consequence, in the UK, Cancer Research UK has already urged caution in the interpretation of these data.

The potential of aspirin to prevent strokes, heart attacks, and colon cancer has been widely publicized in the past, but the general consensus is that the risks of gastrointestinal complications of long-term aspirin therapy may well wipe out any potential benefits. Until we have more data, it may well be the case that the same is true for the potential benefits of aspirin in the prevention of prostate cancer. So … before you rush out to buy your next bottle of enteric-coated “baby” aspirin, The “New” Prostate Cancer InfoLink recommends a careful discussion with your primary care physician. You might be one of those men who would benefit from a regimen of daily, low-dose aspirin, but you might be someone for whom it would be a serious problem too. And if you can’t take an aspirin, maybe a statin is also worth considering — if your doctor is willing to prescribe this.

One Response

  1. Aloha,

    I have been taking regular aspirin since early 1980 to help control my sinuses. Again I seem to be near the beginning of that average curve that covers “no help to helped a lot” with respect to aggressive prostate cancer.


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