The Benefits and Risks of Aspirin

Aspirin and Heart Disease

Since that Californian doctor began handing out aspirin to his patients in the 1940s, dozens of clinical studies have confirmed that people with heart disease who take aspirin have a lower risk of dying. The American Heart Association currently recommends a daily aspirin to all individuals who have had a heart attack unless they have a special reason they cannot take it. Aspirin may also be useful in preventing ]]>stroke]]> in some individuals.

Unfortunately, while aspirin can prevent ]]>heart disease]]> , there are people who should not take it. “Although it is in everyone’s medicine closet, aspirin is a real drug,” says John Baron, MD, Dartmouth Medical Center. Aspirin does have side effects, he notes. Aspirin can cause serious injury to the stomach lining resulting in internal bleeding. It also increases the risk of the type of stroke caused by bleeding in the brain. People who have a history of internal bleeding or gastrointestinal problems must be careful about taking this medicine.

Aspirin and Cancer

Currently, researchers are studying possible links between aspirin and cancer. Scientists believe the COX enzyme is involved in cancer development. Blocking this enzyme with aspirin might prevent certain cancers.

The most conclusive evidence comes from research in ]]>colon cancer]]> . Researchers had noticed that people who took regular aspirin or other similar COX-blocking drugs did not get colon cancer as often as people who didn’t take these drugs.

Scientists decided to test this observation and in March 2003, two studies found encouraging results. In one study, Robert Sandler, MD from the University of North Carolina, Chapel Hill and colleagues looked for colon polyps, a colon cancer precursor, in 517 people randomly assigned to take aspirin or placebo. They found polyps grew in 70 participants (27%) in the group who took the placebo and only in 43 participants (17%) in the group that took aspirin.

A similar study conducted by Dr. Baron and colleagues found that aspirin modestly reduced the chance of developing new polyps even in individuals with no history of colon cancer. In Dr. Baron’s randomized controlled trial, new polyps were detected in 171 participants (47%) in the placebo group, in 140 participants (38%) in the group who took low dose aspirin (81mg), and in 160 participants (45%) in the group who took high dose aspirin (325mg). The researchers were not sure why different doses of aspirin produced different effects.

These two studies provide strong evidence that taking regular aspirin may lower your chance of colon cancer. But, doctors still aren’t sure whether to promote daily aspirin for the prevention of colon cancer. Dr. Baron notes that to prevent colon cancer you may need to take aspirin or a similar COX-blocking drug for fifteen years or more. “And that’s a long time for people to be at risk for bleeding side effects,” he says.

Studying New Links

Research is underway looking at aspirin’s effect on other cancers, including ]]>esophageal]]> , ]]>prostate]]> , and ]]>breast cancer]]> . In fact, in May 2004, Alfred Neugut, MD and colleagues at Columbia University, New York, observed a beneficial link between aspirin and breast cancer. The researchers asked over 2000 women about whether they ever had breast cancer and if they had used regular aspirin, acetaminophen (Tylenol®), or ibuprofen (Advil® or Motrin®) before getting breast cancer. The results showed that 24.3% of women without breast cancer used aspirin, compared with 20.9% with breast cancer. The researchers theorized that women who used aspirin were less likely to also have breast cancer. While this research is promising, more scientific studies that actually compare aspirin to a placebo need to be conducted before definitive conclusions can be made about its effects in breast cancer.

It appears that aspirin, a common and inexpensive drug, may have many positive effects against cancer and heart disease, two of the most common killers of Americans. But, it is not a wonder drug. “We can’t replace other preventive measures,” says Dr. Baron, “even if aspirin is proven to be effective.” Exercise, healthy diets, and regular health screening still play the major roles in preventing these diseases.