Aspirin: A Daily Dose of Defiance Against Colon Cancer for the High-Risk Crowd
Aspirin and colon cancer risk.
As an oncologist, I am particularly interested in reducing the number of people who come to my door.
Today, I read a groundbreaking study in JAMA Oncology.
Researchers report that regular aspirin use may offer a protective shield against colorectal cancer, particularly for individuals with elevated lifestyle-related risk factors for the disease.
This revelation could potentially change the landscape of preventive care for those at higher risk, offering a simple yet effective tool in the fight against this prevalent form of cancer.
Background
Harvard’s Dr. Andrew Chan explains the study objective: “We sought to identify individuals who are more likely to benefit from aspirin to facilitate more personalised prevention strategies.”
Here’s how the researchers accomplished their task:
They analyzed data from women in the Nurses’ Health Study (1980–2018) and men in the Health Professionals Follow-Up Study (1986–2018).
Study Details
The researchers calculated a healthy lifestyle score based on the following:
- body mass index
- alcohol intake
- physical activity
- diet
- smoking.
The investigators assigned scores from 0 to 5, with higher scores corresponding to a healthier lifestyle.
They defined regular aspirin use as two or more standard tablets (325 milligrams) weekly.
Analysis
Dr. Daniel Sikavi and his team meticulously analyzed health data from a vast pool of 107,655 participants enrolled in the Nurses’ Health Study and the Health Professionals Follow-Up Study.
This massive undertaking involved comparing the rates of colorectal cancer between individuals who regularly used aspirin (defined as taking two or more standard 325 mg tablets per week or a daily low-dose 81 mg aspirin) and those who did not.
The study commenced when participants were an average age of 49.4 years, and they were followed for an extensive period, accumulating over 3 million person-years of follow-up data, during which 2,544 cases of colorectal cancer emerged.
Study Findings on Aspirin and Colon Cancer Risk
Here are the compelling results:
Researchers observed a 10-year cumulative incidence of colorectal cancer of 1.98 percent among regular aspirin users, compared to 2.95 percent among those who didn’t regularly take aspirin.
The results show an absolute risk reduction of nearly one percent for regular aspirin users.
More Results
Remarkably, the protective effect of aspirin was most pronounced among individuals with less healthy lifestyles, as measured by factors like body mass index, smoking and alcohol habits, physical activity levels, and adherence to a high-quality diet.
Those with the least healthy lifestyles faced a 3.4 percent chance of developing colorectal cancer without regular aspirin use, but this risk dropped dramatically to 2.1 percent with regular aspirin use.
On the other end of the spectrum, individuals with the healthiest lifestyles showed minimal difference in colorectal cancer rates, regardless of aspirin use (1.6 percent without aspirin vs. 1.5 percent with aspirin).
Aspirin and Colon Cancer Risk: How
The mechanisms behind aspirin’s potential cancer-fighting properties are complex and multifaceted.
Beyond its well-known role as a pain reliever and blood thinner, aspirin may influence the development and progression of cancer through various pathways.
These include its impact on inflammation, a process often implicated in cancer initiation and growth.
Additionally, aspirin may affect cellular processes related to growth and proliferation, potentially hindering the uncontrolled growth characteristic of cancer cells.
Furthermore, it may modulate the immune response, enhancing the body’s ability to detect and eliminate cancerous cells. Lastly, aspirin could influence the blood supply to tumors, potentially starving them of essential nutrients and oxygen.
Aspirin Perils
Moreover, the long-term effects of regular aspirin use, especially at higher doses, on other organ systems, such as the kidneys and liver, should be thoroughly evaluated.
We must also consider potential side effects, such as ear ringing, allergic reactions, and worsening asthma.
Summary – Aspirin and Colon Cancer Risk
Regular aspirin use may offer protection against colorectal cancer, especially for individuals with elevated lifestyle-related risk factors for the disease.
The study analyzed data from a large pool of participants over an extensive period and found that regular aspirin use was associated with a lower incidence of colorectal cancer, particularly among individuals with less healthy lifestyles.
The text also highlights the potential mechanisms behind aspirin’s cancer-fighting properties and points out the need for further evaluation of its long-term effects and potential side effects.
The findings suggest a shift towards more personalized risk reduction strategies based on lifestyle risk assessment.
Aspirin and Colon Cancer Risk: Why I Think This Matters
The landscape of aspirin recommendations has been in flux.
Previously, the United States Preventive Services Task Force (USPSTF) advised daily low-dose aspirin for all adults aged 50 to 59 to prevent cardiovascular events and colorectal cancer.
In 2016, the USPSTF withdrew the recommendation of daily low-dose aspirin for all adults 50 to 59. The group expressed concerns about aspirin’s potential to increase the risk of gut bleeding.
This new study’s findings add another layer of complexity to the debate, suggesting that the benefits of aspirin might outweigh the risks for certain individuals with specific lifestyle risk factors.
Moving to More Personalized Risk Reduction
I wonder if I might someday more strongly consider recommending aspirin to those with less healthy lifestyles.
Lifestyle risk assessment may be valuable for identifying people with a better risk-benefit ratio who should consider aspirin for cancer prevention.
I look forward to seeing the opinions of expert groups.
One more thing:
7 Ways to Drop Your Colorectal Cancer Risk
medium.com
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