Baby aspirin cuts risk for prostate cancer mortality

According to a new report in The Lancet, just published on line, a daily aspirin regimen reduces deaths due to several common cancers — including those caused by prostate cancer.

The report by Rothwell et al., in this week’s issue of The Lancet, is based on data from eight randomized trials (including 25,570 patients and 674 cancer deaths). These trials were originally designed to evaluate the impact of aspirin therapy on risk for cardiovascular events.

We can summarize the data from these trials as follows:

  • When data from all eight trials are considered), patinets randomized to aspirin therapy had a statistically signifciant reduction in risk of death due to any form of cancer (odds ratio [OR] = 0.79).
  • When individual patient data — available from seven of the eight trials (23 535 patients, 657 cancer deaths) — were analyzed , benefit was apparent only after 5 years’ follow-up.
    • For all cancers, the hazard ratio [HR] was 0.66.
    • For gastrointestinal cancers, the hazard ratio was 0·46.
  • The 20-year risk of cancer death (based on 1,634 deaths in 12,659 patients in three trials) remained lower in the aspirin groups than in the control groups.
    • For all solid tumors, HR = 0·80.
    • For gastrointestinal cancers, HR = 0·65
  • The time to evidence of an effect on deaths (the “latent period”) was about 5 years for oesophageal, pancreatic, brain, and lung cancers, but was longer for stomach, colorectal, and prostate cancers.
  • The overall effect on 20-year risk of cancer death was greatest for adenocarcinomas (HR = 0·66), and the vast majority of prostate cancers are adenocarcinomas.
  • The benefit of aspirin therapy was unrelated to aspirin dose (75 mg upwards), sex, or smoking, but increased with age.
  • The absolute reduction in 20-year risk of cancer death was 7·08 percent (range, 2·42 to 11·74 percent) at age 65 years and older.

Now we should be clear that daily aspirin therapy — even with a “baby” dose of aspirion each day of 75 mg — is not risk-free. Long term aspirin therapy is associated with such side effects as gastrointestinal bleeding and with strokes. Men who wish to consider daily aspirin therapy as a means to lower their risk for cardiovascular disorders and cancer should always consult with their physician prior to initiating such a regimen.

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